A pediatric home care program is described which has operated as an ambulatory special care unit in an urban hospital center since 1970. The program provides care for seriously or chronically ill children, who would not be adequately served through traditional ambulatory services because of either the severity and complexity of their medical problems or the inability of their families to use such services. An interdisciplinary PHC team provides comprehensive pediatric care and integrates medical and psychosocial services for the child and family. This form of special ambulatory care appears to offer advantages to patients who are at risk in existing ambulatory schemes and is an alternative to inpatient care.