Many drugs, both approved and in development, exert their effects through transcription factors. The complexity of the biology of transcriptional regulation, however, presents challenges to the effective design of therapies that directly target transcription factors. This review focuses on the different approaches that are currently pursued in therapeutics and drug discovery aimed at targeting transcription factors and signaling molecules, and their areas of effect in transcription factor biology. A relatively recent approach termed "transcription therapy" has been applied for a number of drugs in development, which may potentially provide a new avenue for targeting transcription factors for therapeutic purposes.