This study was designed to document the state of open access (OA) in the biomedical field in 2005. PubMed was used to collect bibliographic data on target articles published in 2005. PubMed, Google Scholar, Google, and OAIster were then used to establish the availability of free full text online for these publications. Articles were analyzed by type of OA, country, type of article, impact factor, publisher, and publishing model to provide insight into the current state of OA. Twenty-seven percent of all the articles were accessible as OA articles. More than 70% of the OA articles were provided through journal websites. Mid-rank commercial publishers often provided OA articles in OA journals, while society publishers tended to provide OA articles in the context of a traditional subscription model. The rate of OA articles available from the websites of individual authors or in institutional repositories was quite low. In 2005, OA in the biomedical field was achieved under an umbrella of existing scholarly communication systems. Typically, OA articles were published as part of subscription journals published by scholarly societies. OA journals published by BioMed Central contributed to a small portion of all OA articles.