The Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994) is often used to assess decision-making deficits in clinical populations. The interpretation of the results hinges on 3 key assumptions: (a) healthy participants learn to prefer the good options over the bad options; (b) healthy participants show homogeneous choice behavior; and (c) healthy participants first explore the different options and then exploit the most profitable ones. Here we test these assumptions using 2 extensive literature reviews and analysis of 8 data sets. The results show that all 3 assumptions may be invalid; that is, (a) healthy participants often prefer decks with infrequent losses; (b) healthy participants show idiosyncratic choice behavior; and (c) healthy participants do not show a systematic decrease in the number of switches across trials. Our findings question the prevailing interpretation of IGT data and suggest that, in future applications of the IGT, key assumptions about performance of healthy participants warrant close scrutiny.