Chronic illness is common in childhood and is associated with an increased risk of psychological difficulties in the child. Current research is focused on the identification of specific risk and protective factors that may predict psychological and health outcomes. The challenges faced by physicians caring for a child with chronic illness are described and contrasted with the medical role in treating acute illness. The child's adaptation to illness is discussed in a developmental framework and positive and maladaptive family responses are identified. It is suggested that chronic illness and/or its treatment may compromise intellectual development and academic progress.