The activity cliff concept is of high relevance for medicinal chemistry. Recent studies are discussed that have further refined our understanding of activity cliffs and suggested different ways of exploiting activity cliff information. These include alternative approaches to define and classify activity cliffs in two and three dimensions, data mining investigations to systematically detect all possible activity cliffs, the introduction of computational methods to predict activity cliffs, and studies designed to explore activity cliff progression in medicinal chemistry. The discussion of these studies is complemented with new findings revealing the frequency of activity cliff formation when different molecular representations are used and the distribution of activity cliffs across different targets. Taken together, the results have a number of implications for the practice of medicinal chemistry.