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Is the healthcare sector prepared to harness synthetic data's transformative potential whilst navigating its hidden pitfalls? This thought-provoking episode delves into the murky waters of synthetic data governance in medical research, examining how generative AI is reshaping our approach to patient information. As algorithms increasingly create convincing facsimiles of real clinical data, we explore the tantalising benefits—enhanced privacy protection, expanded research capabilities, and accelerated innovation cycles—alongside the concerning governance vacuum that threatens to undermine these advances. Our discussion unpacks why the absence of standardised creation and evaluation frameworks is stalling widespread adoption, despite synthetic data's promise. We make the case for urgent development of robust data standards, ethical guidelines and cross-disciplinary collaboration to ensure this powerful tool serves healthcare's highest goals. Join us as we navigate the complex terrain where technological innovation meets patient protection, and discover why establishing clear governance frameworks today is essential for tomorrow's medical breakthroughs. Boraschi D, van der Schaar M, Costa A, Milne R. Governing synthetic data in medical research: the time is now. Lancet Digit Health. 2025 Feb 20:S2589-7500(25)00011-1.