To evaluate the behavior and attitudes among ophthalmology trainees toward pharmaceutical promotions. Questionnaire survey. A questionnaire on behavior and attitudes toward interactions with pharmaceutical representatives was distributed to 110 ophthalmology residency programs in the United States. Responses were collected and analyzed. One hundred and twenty-two responses were received. Most (87%) respondents reported seeing pharmaceutical representatives visiting their program at least once every 1 to 2 months. Most respondents reported having accepted gifts from them. Although only 26% of trainees have changed prescribing behavior based on information provided by pharmaceutical representatives, 77% did so because of available medicine samples. Trainees tended to consider their peers more susceptible than themselves to the influence of pharmaceutical promotions. When asked to rate their agreement to questionnaire statements, with 5 meaning strongly agree and 1 meaning strongly disagree, the average score for "Pharmaceutical representatives influence my prescribing" was only 2.72, compared with 3.67 for "Pharmaceutical representatives influence other physicians' prescribing" (P < .0001). Although half of the trainees (51%) acknowledged that their programs have guidelines or policies regarding interactions with the pharmaceutical industry, only 28% reported having received training in this area. Ophthalmology trainees have frequent encounters with pharmaceutical representatives. The trainees tend to consider their peers more susceptible than themselves to the influence of pharmaceutical promotions. Pharmaceutical representatives seem able to change prescribing practices among trainees they contact by providing information or leaving drug samples. Many trainees have not received any education in this area from their programs.