In the case of Pembaur v. City of Cincinnati, 1985, the U.S. Supreme Court held that a municipality can be held liable under Section 1983 for constitutional violations resulting from actions taken pursuant to official municipal policy by its lawmakers or those whose edicts may fairly be said to represent official policy. The case arose when two deputy sheriffs entered Dr. Pembaur's office without a warrant and used force against him after he refused them entry into his clinic in order to serve subpoenas on his employees who were not present at the time. The deputies acted upon orders from their superiors who had been advised by an assistant county prosecutor that such action was legal despite lacking a search warrant or exigent circumstances justifying forcible entry. The court ruled in favor of Dr.Pembaur stating that if decisions are made by officials with final decision-making authority, then they could constitute "official policy" leading to municipal liability even if it is only one incident rather than part of a pattern or practice.

In the dissenting opinion for PEMBAUR v. CITY OF CINCINNATI et al., 1985, Justice Powell argued that a single decision by a government official cannot establish municipal policy and thus make the municipality liable under §1983. He contended that this interpretation of Monell's "official policy" requirement was too broad and inconsistent with prior case law. Furthermore, he expressed concern about potential implications on federalism principles if municipalities were held accountable for every constitutional violation committed by their employees based on decisions made in the course of their employment. Instead, he proposed to limit municipal liability to cases where there is evidence of deliberate indifference or tacit authorization from policymakers after being informed about unconstitutional actions.