This annual review covers the published literature on the analysis of clinical and biological materials, foods and beverages using atomic spectrometric techniques for the year up to the end of October, 2003. Tables 1 and 2 summarise details of these publications. Our previous Update covered the twelve months up to October 2002. Among the innovations and trends that we have discerned we would note the application of in vivoXRF to clinical studies of Pb metabolism, which follows on from the fine analytical developments of the previous two to three years. The ever popular speciation work is now bearing fruit with identification of new species of As and Se in clinical and foods specimens. Analytical developments include further application of permanent modifiers in ETAAS, of cloud-point extraction to enhance the analyte concentrations prior to measurement and the beginnings of collision or reaction cell technology for ICP-MS.