Tic disorders in childhood vary in severity from transient simple tics to the most bizarre forms of Tourette syndrome. Early diagnosis is important to allow the child and family to understand the problem and to work with them to minimize the social disability caused by the disorder. Pharmacologic treatment will reduce symptoms in 80% to 85% of patients, but nearly one half of patients will have undesirable side effects from the drugs. Attention deficit disorder and learning disabilities are additional problems in between one third and one half of children. The treatment of attention deficit disorder with psychostimulants may exacerbate the tic disorder, making management of these children difficult. A substantial percentage of patients will either have a remission or a marked decrease in symptoms during the second half of adolescence. Because it is impossible to predict which patient will have a remission, and because there is no evidence that treatment will increase or decrease the chance for remission, management of the child and family must be close and continuous.