Abstract: Medical cannabis is increasingly used by Canadian Veterans to manage chronic pain; however, the benefits and harms are uncertain. This commentary summarizes a recent guideline that found small to very small benefits of medical cannabis for pain relief, physical functioning and sleep quality, and evidence for a small to very small increase in several transient harms. The close balance between benefits and harms supports shared decision-making with Veterans living with chronic pain to ensure the decision whether to pursue a trial of medical cannabis is consistent with their values and preferences.