Munchausen syndrome by proxy is a very special and dangerous form of child abuse. It is characterized by a child with symptoms and signs of an illness that have been fabricated by an adult, usually the mother. Fabrication of those signs and symptoms leads to many unnecessary and painful investigations and treatments for the victim. Although many physicians are familiar with the sexual or physical abuse of children, they are unaware of this particular form of child abuse. Fortunately, awareness among pediatricians will increase as more cases are shared in the literature. Diffi culties remain in defi ning the condition, as well as in the detection and differentiation from other illness. Although it is a relatively rare form of child abuse, pediatricians need to have a high index of suspicion when faced with seemingly inexplicable fi ndings or treatment failures. Diagnostic strategies should be case-specifi c and a multidisciplinary approach such as from a “Child Protection Team” is crucial for proper management and effective treatment planning in these cases. This review will discuss the epidemiology and diagnosis of Munchausen syndrome by proxy, as well as the role of the physician in sorting out these cases

Keywords: Child, Child abuse, Munchausen syndrome by proxy