There have been calls amongst academics and practitioners to move social marketing 'upstream'. This paper attempts to clarify what upstream social marketing is, its appropriate relationship with ‘downstream’ social marketing and how both approaches can be combined into a suitable theoretical framework. The paper argues that neither up or downstream social marketing is superior and suggests that a dual, synergistic approach is needed. This argument is supported through reference to current social marketing interventions in the areas of road safety and childhood obesity. The paper concludes by suggesting that Polonsky, Carlson and Fry’s (2003) ‘harm chain’ concept may be a suitable mechanism to locate both approaches into a conceptual framework of practice.