This paper seeks to provide a comprehensive consideration of the full implications of engaging in real earnings management through 1.) an in-depth literature review of selected studies concerning real earnings management, 2.) supplemental interviews to consider real earnings management from various perspectives including supply chain management, accounting and management, as well as 3.) a final framework of the considerations that must be made to fully understand the implications of real earnings management. Though the ethics of real earnings management will be discussed, no determination will be made to support or discredit its use. The methods of real earnings management are plentiful and would benefit most from being judged on a case-by-case basis before coming to any firm conclusions.