This article explores the need for and the problems with digital preservation. Digital documents are much more easily discovered and shared than their analog counterparts, but not only is there a mistaken belief that digital preservation will occur without conscious intervention, there are also outstanding technical issues to be resolved. Even when these problems are recognized, it is unclear what materials should be preserved. Medical librarians have an important role to play in these decisions and should engage with their communities and play an active role in the process.