David Bowie's last studio album was Reality, released in September 2003. He went on a tour of the same name, which was the biggest success of 2004 with an estimated audience of over 3/4 million. However, during the tour Bowie was taken ill with what turned out to be a blocked artery. He had to have heart surgery and the rest of the tour was cancelled. Since then he has made no new albums and generally performed less.

Bowie still does occasional performances, but has done no more tours. He was given a lifetime achievement award in 2006.

An album from his last tour, A Reality Tour, was released in 2010 but it was just recordings from his 2004 tour with no new material. A 2001 album, Toy, also appeared on the internet in 2011 having never previously been released, but this was unofficial and again contained no new tracks.