Munchausen Syndrome by Proxy (MSBP) is characterized by a significant caretaker, usually a mother, deliberately inducing and/or falsely reporting illness in a child. The potentially fatal outcome of undetected MSBP makes the understanding of this syndrome gravely important. Early detection and effective intervention can be accomplished through the continued education of all professionals working with the families of chronically ill children. Psychological testing alone has generally been ineffective in detecting this disorder, so clinicians must review the medical records, corroborate the patient's history, and consult with other professionals involved in the case. Some indicators for identifying these cases include a child who has a persistent, unexplained illness, inconsistent physical or laboratory findings, symptoms that occur only in the mother's presence, or the child's medical history cannot be substantiated. Treatment involves intensive, individual psychotherapy for the identified patient as well as marital and family therapy, making sure to include the siblings of the victim. Therapy must follow through several stages where trust is established before the abuses may be addressed. Patients must come to understand the cognitive distortions and emotional dissociation which allowed them to engage in the abusive behavior toward their child. (RJM)