The production of Tibetan pharmaceuticals underwent a far-reaching transformation over the past decade. The introduction of good manufacturing practices (GMP) marked the beginning of rapid industrialization: new factories were built, and the companies re-oriented themselves to the requirements of the market. While officially regarded a great success, many doctors and pharmacists see GMP as fundamentally incompatible with traditional production methods and notions of quality. In this article, I address this incompatibility and examine where and how it affects the actual practice of producing medicines. While the problem exists, I argue that it does not stem from conflicting epistemologies but rather from the side effects of a quick and forced implementation, which often contradicts the spirit and letter of the regulations themselves. The case sheds new light on the way in which ideas about quality and safety, forged in the global arena, are locally recontextualized.