Estimates of wind-induced wind effects on tall buildings are based largely on 1980s technology. Such estimates can vary significantly depending upon the wind engineering laboratory producing them. We describe an efficient database-assisted design (DAD) procedure allowing the realistic estimation of wind-induced internal forces with any mean recurrence interval in any individual member. The procedure makes use of (a) time series of directional aerodynamic pressures recorded simultaneously at typically hundreds of ports on the building surface, (b) directional wind climatological data, (c) micrometeorological modeling of ratios between wind speeds in open exposure and mean wind speeds at the top of the building, (d) a physically and probabilistically realistic aerodynamic/climatological interfacing model, and (e) modern computational resources for calculating internal forces and demand-to-capacity ratios for each member being designed. The procedure is applicable to tall buildings not susceptible to aeroelastic effects, and with sufficiently large dimensions to allow placement of the requisite pressure measurement tubes. The paper then addresses the issue of accounting explicitly for uncertainties in the factors that determine wind effects. Unlike for routine structures, for which simplifications inherent in standard provisions are acceptable, for tall buildings these uncertainties need to be considered with care, since over-simplified reliability estimates could defeat the purpose of ad-hoc wind tunnel tests.