New paradigms are shrinking our world. Tiny is in and patents are essential for success in nanomedicine. In fact, patents are already shaping this nascent and rapidly evolving field. For the past decade a swarm of patent applications pertaining to nanomedicine has been arriving at the US Patent and Trademark Office (PTO). As companies develop products and processes and begin to seek commercial applications for their inventions, securing valid and defensible patent protection will be vital to their long-term survival. As we enter the "golden era" of medicine, or nanomedicine, in the next decade with the field maturing and the promised breakthroughs accruing, patents will generate licensing revenue, provide leverage in deals and mergers, and reduce the likelihood of infringement. Because development of nanobiotechnology- and nanomedicine-related products is extremely research intensive, without the market exclusivity offered by a US patent, development of these products and their commercial viability in the marketplace will be significantly hampered. In this article, we highlight critical issues relating to patenting nanomedicine products. Effects of the "nanopatent land grab" that is underway in nanomedicine by "patent prospectors" are examined as startups and corporations compete to lock up broad patents in these critical early days. Because nanomedicine is multidisciplinary, patenting presents unique opportunities and poses numerous challenges. Although patents are being sought more actively and enforced more vigorously, the entire patent system is under greater scrutiny and strain, with the PTO continuing to struggle with evaluating nanomedicine-related patent applications.