This chapter provides an overview of a number of issues involved in assessing some of the uses and dangers involved in the proliferation of ballistic missiles and evaluates the efforts to control their spread. One of the questions that constantly arises is the military significance of ballistic missiles as compared with other forms of weapons delivery, particularly aircraft. In terms of pay load, aircraft typically carry greater and more diversified ordnance, especially of nuclear and chemical weapons. In terms of accuracy, most Third World missiles are very inaccurate compared with those in the industrialized world. In 1982 the Reagan administration instituted the NSDD-70, which comprised an examination of the ways in which ballistic missiles might be controlled. This culminated the following year in negotiations between the United States and Canada, Italy, France, Japan and the United Kingdom essentially to formulate the Missile Technology Control Regime.