Internationally, the threat from biological warfare agents includes bioterrorism, and it can not be excluded that pathogens could be used in a terrorist attack also in Sweden. A scenario where the potential user has a relatively low competence has to be considered possible, while a scenario where a large number of people contract highly infectious diseases is less likely. However, it is still important to discuss also this type of event in order to evaluate the medical preparedness required to meet these threats. In this report, two different scenarios are discussed, one with relatively limited consequences and the other with more severe consequences, i.e. a large number of people infected with a highly pathogenic organism. Based on these scenarios the need for antibiotics, identification and medical treatment are discussed. In the case of bioterrorism all categories of people are at risk and the aim must be to provide rapid, adequate treatment with minimised side effects. In order to minimise the consequences it is essential to rapidly identify the organism used. Antibiotic resistance is a potential problem and in a national preapredness plan including sampling and rapid identification, routines for antibiotic resistance determination should also be added. Another important issue is to use media to quicly inform the public about the situation in a professional way. A medical preparedness based on possible scenarios of bioterrorism in Sweden would serve to minimise the consequences on society. Countermeasures to meet the spread of fear and panic in connection with these types of events will further reduce the consequences.