While direct-to-consumer (DTC) prescription drug advertising has been the subject of ongoing debate, to this point the perspective of the advertising professionals engaged in creating these ads has been absent from the discussion. This study, consisting of in-depth interviews with advertising professionals (N = 22), was an initial investigation focused on these individuals. The primary purpose of this study was to explore advertising professionals' understanding of health literacy-consumers' ability to obtain, process, and act on health information; with that context in place, participants' views on the role of DTC advertising, industry regulations, and the future of the industry were also investigated. While some participants knew nothing about health literacy or had a relatively simple conceptualization (e.g., grade level of written materials), others exhibited more nuanced understanding of health literacy (e.g., the need to pair relevant images with text to enhance understanding). Participants spoke of the potential public health benefit of DTC advertising in educating consumers about health issues, but were realistic that such efforts on the part of pharmaceutical companies were driven primarily by business concerns-educational messages need to be tied directly to an advertised medication and its benefits. These professionals spoke of industry regulations as presenting additional barriers to effective communication and suggested that industry trends toward more niche products will necessitate more patient education about less well-known health issues. Directions for future research are considered, as more investigation of this understudied group is necessary to enrich the DTC prescription drug advertising debate.