Childhood social anxiety disorder is a condition of complex origins. Longitudinal studies of shyness and behavioral inhibition, and twin and family history studies, support a genetic component, but experiences such as family environment, parenting, and traumatic conditioning also are observed. Many children with significant shyness and behavioral inhibition do not develop social anxiety disorder, reinforcing the need for longitudinal studies exploring resiliency and risk factors that can be incorporated into diathesis stress models. Efficacy data regarding cognitive and behavioral therapies and pharmacotherapy are promising, and their effectiveness awaits further research. These studies will need to incorporate a multiplicity of perspectives to ensure the long-term sustainability of interventions for social anxiety disorder in children and adolescents.