Interest in the biology of the microtubule-associated protein tau, not only as a pathologic marker, but as a therapeutic target has surged considerably over the last few years. This is due, in part, to the discovery of mutations in tau causing a group of aggressively degenerative neurologic disorders characterized by abnormalities of tau very similar to what is seen in Alzheimer's disease where mutations in tau are absent. As these same mutations also precipitate authentic forms of neurofibrillary degeneration in tau transgenic mice, the gateways to testing therapeutic ideas preclinically have opened. Other Alzheimer's disease animal models have been notoriously bare of this feature, limiting their predictive power for clinical success. In this review, the authors discuss some of the main therapeutic ideas presently advanced in the field and their molecular rationales.