The use of gambling activities (i.e., raffles, casino nights, pull tabs, and lotteries) as a means of generating hospital revenue has become a widespread phenomenon across Ontario. This research examined gambling policy and practices in Ontario hospitals and foundations. The primary purpose of the study was to explore how hospitals decide whether they are going to use gambling for fund development. Findings include that hospitals have little consideration of the potential costs, including the impacts on mental health and family human risks, of these activites.