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‪Since the beginning of the 2000s, Randomized Controlled Trials (RCTs) have returned to center stage, both in the economics of development and in the evaluation of public policy. Despite the fact that RCT promoters claim a filiation with medicine, these economists seem unfamiliar with the literature around clinical trials. This article aims to overcome this limitation, by comparing the use and the limits of RCTs between medicine and economics. I show that while this method is considered to be the “gold standard” of evidence in medicine, some limits exist and have to be taken into account in economics. I also show how the way in which the problem of external validity is addressed in medicine provides arguments to obtain a more nuanced picture of the interest of RCTs in economics.‪