Gambling has grown worldwide as a result of government policy decisions to legalize different forms of gambling and increase citizens’ access to gambling opportunities. Yet governments have been slow to commission research that examines the socioeconomic impact of gambling in society. The First International Symposium on the Economic and Social Impact of Gambling was held in Whistler, British Columbia, Canada, from September 23-27, 2000. Sixty gambling researchers, economists, politicians, government agency officials, and gaming industry representatives from Canada, the United States, Australia, the United Kingdom, and Europe were invited to discuss and debate various perspectives, definitions, and methods for assessing the social and economic impacts of gambling in society. The theory and context around gambling impact analysis is examined. Researchers identify a remarkable range of estimates of the costs of gambling, and the direct attribution of costs to gambling as distinct from merely being associated with gambling. The issue of the typology of social costs and benefits of gambling are examined, including the methodological issues respecting social cost estimation, and a model for identifying and measuring the impacts of pathological gambling is presented. The application of the principles of economic theory and methods to particular impact analysis situations is discussed. Several weaknesses with many gambling cost-benefit studies are identified. A recently developed set of guidelines for estimating the economic costs of substance abuse is described, and the implications for the development of guidelines for estimating the costs and benefits of gambling are discussed. Finally, gambling is examined from a public health perspective.