The Medical Research Council is a publicly-funded organisation dedicated to improving human health. It supports research across the entire spectrum of medical sciences, in universities and hospitals, in its own units and institutes in the UK and in Africa. The MRC works closely with key stakeholders and research funders - UK health departments, other departments and agencies, the six sister research councils, industry, and the academic and charity sectors - giving a high priority to research that is likely to make a real difference to clinical practice and the health of the population. This annual report describes progress in 2008-09, highlights key awards and partnerships, and outlines plans for the future.