Objective: The authors describe the approval processes for subspecialties and the mechanisms for certification and recertification and review the status of training programs and numbers of diplomates with subspecialty certification. Methods: Published information and relevant data bases were reviewed. To date, 5,327 child and adolescent psychiatry, 2,595 geriatric psychiatry, 1,854 addiction psychiatry, and 1,384 forensic psychiatry certificates have been awarded. In clinical neurophysiology and pain medicine, specialties that are primarily for neurologists and child neurologists, 21 and 28 psychiatrists, respectively, have been certified. There are 113 residency programs in child and adolescent psychiatry, 62 in geriatric psychiatry, 43 in addiction psychiatry, and 40 in forensic psychiatry. There are no psychiatry-based training programs in clinical neurophysiology and pain medicine. While this may not be of concern for clinical neurophysiology, it may lessen psychiatry's contribution to pain medicine. Results: The ABPN took a conservative approach to establishing subspecialty certification in psychiatry. Conclusion: It is expected that subspecialists will enhance patient care through their clinical activities as well as through teaching and research.