Computational target prediction for bioactive compounds is a promising field in assessing off-target effects. Structure-based methods not only predict off-targets, but, simultaneously, binding modes, which are essential for understanding the mode of action and rationally designing selective compounds. Here, we highlight the current open challenges of computational target prediction methods based on protein structures and show why inverse screening rather than sequential pairwise protein-ligand docking methods are needed. A new inverse screening method based on triangle descriptors is introduced: iRAISE (inverse Rapid Index-based Screening Engine). A Scoring Cascade considering the reference ligand as well as the ligand and active site coverage is applied to overcome interprotein scoring noise of common protein-ligand scoring functions. Furthermore, a statistical evaluation of a score cutoff for each individual protein pocket is used. The ranking and binding mode prediction capabilities are evaluated on different datasets and compared to inverse docking and pharmacophore-based methods. On the Astex Diverse Set, iRAISE ranks more than 35% of the targets to the first position and predicts more than 80% of the binding modes with a root-mean-square deviation (RMSD) accuracy of <2.0 Å. With a median computing time of 5 s per protein, large amounts of protein structures can be screened rapidly. On a test set with 7915 protein structures and 117 query ligands, iRAISE predicts the first true positive in a ranked list among the top eight ranks (median), i.e., among 0.28% of the targets.