Places third in the presidential election

In the 1988 presidential election, Paul defeated American Indian activist Russell Means to win the Libertarian Party's nomination for the U.S. Presidency.

Appearing on the ballot in 46 states and the District of Columbia, he placed third in the popular vote (with 431,750 votes — 0.47%), behind Republican George H. W. Bush and Democrat Michael Dukakis. Although he had been an early supporter of Ronald Reagan, Paul was critical of the unprecedented deficits incurred by Reagan's administration, for which Paul's opponent George H.W. Bush had been vice-president.

During his time as a Libertarian candidate, Paul gained supporters nationwide who agreed with him on many of his positions — on gun rights, fiscal conservatism, home-schooling, and abortion, and he won approval from others who thought the federal government was heading in the wrong direction on other issues. These supporters formed a nationwide support base that encouraged him to return to office and supported his campaigns financially.

Paul said that he was trying to do more during his presidential run than reach office: he was trying to spread his liberty-minded ideas and would often talk to school groups that weren't old enough to vote. "We're just as interested in the future generation as this election. These kids will vote eventually, and maybe, just maybe, they'll go home and talk to their parents."

After the election, Paul had a coin business,began his own think tank, the Foundation for Rational Economics and Education, and continued his medical practice until he returned to Congress.

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