Overweight and obesity are increasing dramatically in the United States of America, especially among children. Effective treatment of the multiple risk factors that promote youth obesity requires treatment approaches that are flexible and comprehensive enough to address each of these factors. One such treatment approach is Multisystemic Therapy (MST), an empirically supported, intensive home-based treatment approach that has been proven effective with other childhood chronic illnesses and which has recently been adapted to treat youth with obesity. This case report describes the use of MST to treat an obese 15-year-old African American boy during the course of a pilot study designed to determine the feasibility of MST for African American youth. (Contains 1 table and 2 figures.)