Adjuvant chemotherapy plays an important role in improving disease free and overall survival in women with high-risk early stage breast cancer. While more than seventy thousand women have enrolled in taxane-based adjuvant chemotherapy studies, interim and final results are available from several of these randomized phase III adjuvant studies. In this review, we will summarize the design and outcomes from the reported trials, and draw conclusions about the role adjuvant taxanes now play in the standard management of operable breast cancer. In aggregate, these studies show that adjuvant taxanes can improve important clinical outcomes beyond those achieved with anthracycline-based chemotherapy, without imparting prohibitive acute or chronic toxicities. Important questions are being addressed in ongoing adjuvant trials, including comparisons of combination to sequential therapy, direct comparisons between paclitaxel and docetaxel, and how to safely integrate targeted therapies into these highly active adjuvant regimens.