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Sample preparation is a key step in proteomics, however there is no consensus in the community about the standard method for preparation of proteins from clinical samples like tissues or biofluids. In this chapter, we will discuss some important steps in sample preparation used for bottom-up proteome profiling with mass spectrometry (MS). Specifically, tissues, which are an important source of biological information, are of interest because of their availability. Tissues are most often stored as fresh frozen (FF) or formalin-fixed paraffin-embedded (FFPE). While FF tissues are more readily available, paraffin embedding has historically been routinely used for tissue preservation. However, formaldehyde induced crosslinks during FFPE tissue preservation present a challenge to the protocols used for protein retrieval. Moreover, in our view, an important aspect to consider is also the amount of material available at the start of a protocol since this is directly related to the choice of protocol in order to minimize sample loss and maximize detection of peptides by MS. This “MS sensitivity” is of special importance when working with patient samples that are unique and often available in limited amounts making optimization of methods to analyze the proteins therein important given that their molecular information can be used in a patients’ diagnosis and treatment.