This article provides an overview of the use of paroxetine in the treatment of mood and anxiety disorders in children and adolescents. Although not currently approved for use in patients younger than 18 years of age, the efficacy and safety of paroxetine have been studied in several pediatric mood and anxiety disorders. The epidemiology, diagnosis, and course of major depression, obsessive-compulsive disorder, social anxiety disorder, and panic disorder are discussed briefly. Current available data on the safety and efficacy of paroxetine based on double-blind, placebo-controlled trials and open-label studies for the treatment of mood and anxiety disorders in children and adolescents are reviewed. Clinical guidelines for the use of paroxetine in children and adolescents and recommendations regarding future directions of study are discussed.