Optimism regarding the treatment and prevention of Alzheimer disease has begun to replace the attitude of therapeutic nihilism that clouded the field for so many decades. Neurotransmitter-based therapy with AChEls and NMDA receptor antagonists are now in current use; anti-inflammatory and anti-oxidative approaches as well as compounds to block Abeta aggregation are being tested in the clinic; beta- and gamma-secretase inhibitors designed to reduce generation of Abeta peptides are under development. One of the more provocative developments in this field was the idea of vaccination against beta-amyloid. Despite vivid antagonism that was rapidly voiced by many concerned experts, there are actually several excellent reasons why brain beta-amyloid plaques are attractive immunotherapeutic targets for the treatment and prevention of AD.