Traditional drug design has been effective in the development of therapies for a variety of disease states but there is a need for new approaches that will tackle new challenges and complement current paradigms. The use of metals in medicine has resulted in several successes and allows for the introduction of properties that cannot be achieved by use of organic compounds alone, but also introduces new challenges that can be addressed by a careful understanding of the principles of inorganic chemistry. Toward this end, the unique structural and coordination chemistry, as well as the reactivity of metals, has been used to design novel classes of therapeutic and diagnostic agents. This review briefly summarizes progress in the field of therapeutics, from the earliest use of metals to more recent efforts to design catalytic metallodrugs that promote the irreversible inactivation of therapeutically relevant targets.