The mechanism of action, antibacterial spectrum, pharmacokinetics, current dosage recommendations, adverse reactions, therapeutic uses, and pharmaceutical considerations of moxalactam disodium are reviewed. Moxalactam is a synthetically derived, structurally unique beta-lactam antibiotic. Its antimicrobial activity encompasses a wide spectrum and includes some strains of pseudomonal species. Administered by i.v. or i.m. injection, moxalactam is widely distributed to body fluids and tissues. Its elimination half-life is longer than those of first- and second-generation cephalosporins. Usually administered in two or three divided doses daily, moxalactam has been shown to be effective against specific organisms in a variety of infections, including lower respiratory, urinary-tract, intra-abdominal, central nervous system, skin and skin-structure, and bone and joint infections, and bacterial septicemia. Adverse reactions associated with moxalactam administration have been limited and appear similar to those experienced following the use of other beta-lactam antibiotics. Because of its wide spectrum of activity, colonization of resistant organisms and (to a lesser extent) superinfection may complicate therapy. Early clinical experience indicates that moxalactam is effective for the treatment of a number of bacterial infections, including those involving the abdominal cavity and respiratory and urinary tracts. More experience is necessary to delineate its most appropriate roles in specific infectious processes.