The human genome encompasses some 2,000 proteins that utilize adenosine 5-triphosphate (ATP) in one way or another and some 500 of these are protein-tyrosine and protein-serine / threonine kinases (PTKs & PSTKs). Substrate phosphorylation by these enzymes is natures predominant molecular way of organizing cellular signal transduction and regulating biochemical processes in general. It is not surprising, therefore, that abnormal phosphorylation of cellular proteins is a hallmark of disease and that there has been a growing interest in the use of kinase inhibitors as drugs. In fact the search for such agents has recently culminated in the approval of the first kinase inhibitor drugs for medical use. Although it has been demonstrated exhaustively that potent and structurally diverse ATP-antagonistic small molecule kinase inhibitors can be found through mass screening and structure-guided design, the question of biochemical, cellular, and in vivo selectivity of such inhibitors remains much less clear. Here the medicinal chemistry of kinase inhibitors is reviewed critically with particular emphasis on target selectivity and specificity. Approaches based on chemical genomics, combinatorial target-guided ligand as sembly, computational chemistry, and structural biology techniques, which aim at classifying both inhibitors and kinase targets, are given special emphasis. The various strategies in which differences in biochemical mechanism of kinase function can be exploited in order to attain selective inhibition are also discussed. Furthermore, recent developments in the design of inhibitors to selected individual validated therapeutic kinase targets, including cell cycle kinases and receptor PTKs, etc. are summarised.