Released in December 2003, Pristine boasted a 199-card set divided up into 100 veteran player cards and 99 rookie player cards. The cards alternate where each player has three cards in a row and the first card is the common, also the rookie card, the second is uncommon sequentially numbered to 999 and the third is rare and sequentially numbered to 499. Pristine was packaged five packs per box where each pack contained three individual packs and cards were inserted as follows: Pack one (the outermost pack) contains one uncirculated Refractor, Relic Refractor or Gold Autograph sealed in a holder. Pack two contains one relic card plus pack three. Pack three contains four Topps Pristine veteran cards plus two Rookie cards.

The top-trending card in 2003 Topps Pristine may currently be the #101 base LeBron James, but Carmelo Anthony, Chris Bosh and Dwyane Wade follow closely behind in popularity. After one season at Syracuse, Anthony entered the 2003 NBA draft and was selected with the third overall pick by the Denver Nuggets. While playing for Denver, he led the Nuggets to the playoffs every year from 2004 to 2010; the team won two division titles in that span.