The primary reason for outsourcing preclinical research to a contract research organization (CRO) tends to be consolidation of infrastructure and lowering of fixed operating costs. According to a study conducted by The Tufts Center for the Study of Drug Development (Tufts CSDD), sponsors primarily make the decision to outsource because they believe the CRO is more cost-efficient and time-efficient than internal teams and they want to take advantage of the efficiency and capacity potential that these external players can offer. The study also showed that a sponsor’s primary criterion for selecting a CRO is its reputation to deliver on these cost-savings capacities. The preclinical CRO is therefore under immense pressure to conduct studies and deliver results in a cost-effective and efficient way. Ideally, the facility will have the ability to spread overhead costs, including expert staff and equipment, over a large number of preclinical studies from different clients. But there are several factors that may influence their ability to do just that including: variables related to their own infrastructure, capacity and capability across each unique study and client. Challenges surface when the CRO is spread too thin and can no longer provide individualized focus on the services they provide. When this happens, quality of service falls short and so there is a careful balance for the CRO between taking on the right amount of work and maintaining the highest possible quality of work; but one constant remains: reputation is always on the line.