There is increased interest in the use of best-worst scaling (BWS) as a method of preference elicitation in health. However, the method is undergoing rapid development in several fields, making dissemination of new insights challenging. Furthermore, there are two types of BWS that have hitherto received little interest in health, but that are uniquely placed to address certain issues. This article offers an update of the state of play of BWS, presents original research to illustrate new methods of analysis and introduces to health researchers some issues on the research frontier.