The clinical interpretation of trace element analysis has lagged behind the technology available to measure the elements in body fluids. Reports can be difficult to interpret and requires knowledge of toxicokinetics, the dynamics of how the trace metals accumulate and pass through the body. Trace element analysis is best used for specific applications, such as establishing levels of exposure, biological exposure indices, biomonitoring of populations, and to confirm an association following a compatible diagnosis. It is not well suited for screening individual patients. Chelation treatment may follow inappropriate trace element determinations and may carry a risk of side effects, some life-threatening. Trace element analysis should be used sparingly and with full understanding of what the results are likely to mean. The physician should only order the test with a clear idea of why he or she is doing so and what he or she will do with the result.