The present article is a critical analysis of the epistemological, methodological, and pragmatic foundations of evidence-based practice as they affect the profession of music therapy. The article is situated within a narrative presentation of the author’s background in the philosophy and history of science, and in experimental psychology. Areas of critique include narrow understandings of the nature of science, restrictive notions of evidence, methodological issues in the randomized controlled trial, the medical model and its associated illness ideology as an inadequate model of music therapy, the concept of an intervention as an inadequate conceptualization of what makes music therapy work, and the potentially corrupting effect of commercial influences in research.