The author discusses the evolution of psychiatric peer review in Washington, D.C. In its first six years (1972-1977) the Washington Psychiatric Society Peer Review Committee evaluated 146 cases, 23 (16%) of which focused on group therapy. Eight of these cases (35%) were partially or fully denied. Most of the cases involved outpatients with neuroses or character disorders who were treated in combined group and individual therapy. The author presents specific cases illustrating group therapy issues and peer review decisions. He discusses the benefits and liabilities of peer review and emphasizes its importance as a flexible, clinically sensitive, confidential, and meaningful process.