The term evidence-based medicine (EBM) was first used in 1991 but its roots began hundreds of years earlier. Over the past 35 years it has evolved considerably into its present-day application. This commentary reviews the history of EBM to the present day, and where the future of EBM may lead over the coming decade. It describes how clinical practice based on personal experience, tradition and anecdotes evidence-based medicine transformed to clinical practice that relies upon a hierarchy of scientific evidence, the comprehensive aggregation and timely access of information and the incorporation of patient values.