Conventional non-steroidal anti-inflammatory drugs (NSAIDs) inhibit the metabolism of arachidonic acid to proinflammatory prostaglandins (PGs) by cyclooxygenase COX-1 and COX-2. Non-steroidal anti-inflammatory drugs provide important analgesic and anti-inflammatory benefits to millions of patients, but are associated with a number of serious adverse events. These include gastrointestinal toxicity, renal impairment, cardiovascular and thromboembolic complications. The mechanism underlying the serious complications associated with conventional NSAIDs and selective cyclooxygenase COX-2 inhibitors treatment is more complicated than simple imbalance between COX-1 and COX-2 inhibition and still is not clear. A recent opinions on benefit-risk balance associated with NSAIDs treatment are presented in this report