Proteins are generally poor drug candidates due to bioavailability pro
blems that stem from conformational instability, susceptibility to pro
teolytic degradation, poor membrane penetration, and unfavourable phar
macokinetics. Since many proteins exert their biological activity thro
ugh relatively small regions of their folded surfaces, their actions c
ould in principle be reproduced by much smaller 'designer' molecules t
hat retain these localised bioactive surfaces but have potentially imp
roved pharmacokinetic/dynamic properties. Unlike proteins, smaller pep
tides generally lack well defined three dimensional structure in aqueo
us solution and tend to be conformationally mobile. Considerable progr
ess has been made in recent years towards the use of molecular constra
ints to stabilise bioactive conformations. By affixing or incorporatin
g templates that fix secondary and tertiary structures of small peptid
es, synthetic molecules (protein surface mimetics) can be devised to m
imic the localised elements of protein structure that constitute bioac
tive surfaces. This is a promising growth area of medicinal chemistry
that could impact significantly on biology and medicine. In this persp
ective review we summarise and prescribe methods for mimicking individ
ual elements of secondary structure (helices, turns, strands, sheets)
and for assembling their combinations into tertiary structures (helix
bundles, multiple loops, helix-loop-helix motifs). A detailed understa
nding of the features that stabilise secondary and tertiary structures
is the key to developing appropriate templates to support and correct
ly position residues in smaller folded surfaces. The goal is to direct
critical amino acids (or surrogates) into the same conformational spa
ce and orientation as in bioactive surfaces of a native protein, yet r
etain sufficient flexibility to bind cooperatively, and with complemen
tarity, to a given receptor. The requirements of size, shape, and dire
ctionality for templates to control peptide assembly and folding are d
iscussed in relation to selected mimetics of secondary and tertiary st
ructures. Particularly striking is the general tendency for protease i
nhibitors and MHC-binding peptides to adopt strand conformations; agon
ists and antagonists for G protein-coupled receptors to predominate in
turn structures; transcription factors, cytokines and DNA/RNA-binding
motifs to be helical; and antigen-recognition segments of antibodies
to involve multiple loops.