This study examined the effects that online asynchronous dilemma discussions have on moral reasoning scores of pharmacy students. In contrast to face-to-face group discussions, asynchronous threaded discussions afford all participants time to reflect and respond during discussions. Anonymity features may lessen inhibitions in responding critically to others and engaging in sensitive discussions. Moral reasoning scores of participants in the online and online with anonymity discussion groups significantly increased over time; however, those gains were not significantly different from the traditional discussion and control groups. Asynchronous online discussion strategies may be useful for increasing moral reasoning skills in distance education settings. (Contains 2 tables and 1 figure.)