Introduction: This paper analyzes the ways in which the International Olympic Committee (IOC) confronted and made critical policy decisions based on highly technical scientific and medical knowledge, in the period leading up to and including the 1960s. Methods: This paper utilizes the historical method to examine the topics of science and medicine within the Olympic Movement. Additionally, it brings an external and analytical perspective to a question that has thus far been examined either from an intestine approach or in an extensively descriptive manner. Research is drawn from primary sources such as scientific and medical reports from the 1960s, press reports about athletics and science, and the archives of the IOC (including reports of the nascent Medical Commission and correspondence among members of the Commission and the IOC). The 1960s were a crucial time for the IOC; particularly in the way that this group comes to understand the enormous amount of scientific information that became critical to the conduct of elite sport in that decade. Results: Prior to the 1960s, the IOC rarely had to deal with matters of a scientific or medical nature. When necessary, FIMS was consulted in these matters. In the 1960s, however, the IOC was forced to hastily confront complex scientific and medical information and struggled to create a process to assist in understanding altitude physiology, drug testing and gender verification. The composition and influence of the IOC Medical Commission at its inception continues to influence the Commission more than 30 years later. Discussion: The IOC continues to be confronted with critical decisions based on highly technical scientific and medical knowledge. Over the past 30 years the Medical Commission of the IOC has emerged as the vehicle through which this information is analyzed by the IOC. A better understanding of how certain institutions within the elite sports world were created can help us to understand the institution and its operation today. Recent historical research seems to suggest that the IOC was slow in responding to the doping issue in the past. The organization of the IOC was, in large part, responsible for any tardiness. Scientific issues that emerged in the 1960s are still the focus of debate today. There is a belief that the athletes, who “by an accident of geography” are born, grow up and train at a high altitude, are predisposed to success in distance events in track and field. The problem of doping in sport has yet to be eliminated. The more sophisticated the testing procedures become, the savvier some athletes and trainers become in evading those tests. It is not only the money that has entered the previously amateur Olympics that pushes some athletes to take performance enhancing drugs, the fame associated with an Olympic medal is also a motivating factor. The IOC decided, perhaps because of social (not just scientific or medical) pressure, to end the test for gender at the 2000 Games in Sydney (unless accusations were made about a specific athlete). Acknowledgements: Research for this project was funded, in part, by the Postgraduate Research Grant Programme, 1999, of the IOC Olympic Studies Center and the Olympic Museum.