The reviewers who serve at the National Institute of Health (NIH) study sections are in the unique position of identifying the most scientifically meritorious grant applications for consideration for funding. Consequently, the reviewers guide the direction of scientific discoveries in the US, which ultimately translate to patient care. Recently many investigators have expressed concerns about the quality of the reviews that they received from the National Heart, Lung, and Blood Institute (NHLBI) study section reviewers. I discuss some of these concerns, identify some of the deficiencies, and make suggestions to the reviewers on how to improve their review of the grant applications.