In this article an International Law and policy perspective is applied to the US Special 301 approach to the management of intellectual property rights of foreign States – with emphasis on the pharmaceutical sector and transfer of technology against the backdrop of US China trade tensions. In particular, the article draws upon the US Special 301 Reports between 2018 to 2020. The paper sets out to take a critical stance of Special 301. This evaluation is intended to equip in particular those who are at the receiving end of the Special 301mechanism. The paper concludes that Special 301 is lacking in informed, expert and empirically based inputs. Above all it lends itself to being hijacked by the narrow agenda of the executive without adequate international, constitutional and due process safeguards for those it is targeted at.