The natural polyamines putrescine, spermidine and spermine are intimately involved in growth-related processes. More and more evidence indicates that the excessive accumulation of putrescine and spermidine favors malignant transformation of cells. Selective depletion of putrescine has been shown to restore in some transformed cells the normal phenotype. Inhibition of polyamine formation appears, therefore, a rational target in chemoprevention. Clinical trials with 2-(difluoromethyl)ornithine, a selective inactivator of ornithine decarboxylase, a key enzyme of polyamine biosynthesis, are promising. Structural analogs of the polyamines with polyamine-mimetic or antagonist properties, and calmodulin antagonists are other types of drugs which affect several key reactions of polyamine metabolism, and appear to be candidates for the prevention of carcinogenesis especially of the gastrointestinal tract.