When a clinical trial does not unfold as planned, it may be heading for rescue. Communication problems among stakeholders, patient enrollment delays, overly complex protocols, and poor site compliance are just a few of the many reasons why rescue action is needed. The issue of study rescue is increasingly faced by contract research organizations (CROs) as it has been estimated that by 2020, 70% of all clinical trials will be outsourced to CROs, a trend that frees sponsors to re-focus their energies on core competencies. With this model, the goal of better on time and on budget performance—essentially avoiding rescue—has often become the responsibility of the CRO. But what happens when a rescue is needed and what can CROs do to avoid it?