Application of a turning points analysis to detailed chronologies of events that transpired prior to and during two matched cases of multilateral intellectual property rights (TRIPS) negotiations yields useful lessons for understanding negotiation process and effective negotiator behavior. The unfolding negotiation process is traced in the GATT Uruguay Round and prior to and during the WTO Doha Ministerial. Departures from earlier trends in the chronologies merit special attention. A departure is defined as a clear and self-evident change from earlier events or patterns in the form of an impactful decision taken by one or more parties. By coding the causes (precipitants) and effects (consequences) of the departures, we perform a turning points analysis. The turning points analysis, composed of three-part sequences, reveals the triggers and impacts of departures during the extended TRIPS negotiation process. The analyses will allow a comparison of the patterns that unfolded during the two phases of TRIPS negotiations, which will highlight the breakthroughs that occurred during the Uruguay Round and the crises that emerged later, prior to and during the Doha Ministerial. Improving the effectiveness of multilateral trade negotiations depends in part on understanding how critical turning points emerge.