Aim To conduct a follow-up survey ascertaining changes in usage, referral rate, beliefs and attitudes towards complementary and alternative medicine (CAM) during the last decade. BACKGROUND: In many countries, CAM use is reported to be substantial and increasing. METHODS: A questionnaire was posted to all GPs registered with the Liverpool Primary Care Trust. Respondents were asked whether they treat, refer, endorse or discuss eight common CAM therapies and about their views on National Health Service (NHS) funding, effectiveness, CAM training needs and theoretical validity of each therapy. Comparisons were made between these results and those collected in 1999. Findings The response rate was low (32%) compared with the 1999 survey (52%). The main findings were similar to the most popular therapies still being acupuncture, hypnotherapy and chiropractic and the least being aromatherapy, reflexology and medical herbalism. GPs felt most comfortable with acupuncture, with greater belief in its theoretical validity, a greater desire for training and a greater support for acupuncture to receive NHS funding than for the other CAM therapies under question. Opinions about homeopathy had become less supportive. Overall, GPs were less likely to endorse CAMs than previously shown (38% versus 19%).