Although the incidence of Reye's syndrome is declining, it remains a deadly disease. Early recognition and initiation of supportive measures can decrease the mortality rate from this disorder. Glucose levels should be maintained and electrolyte imbalances and coagulopathies should be corrected in patients with early Reye's syndrome. Comatose patients require specialized care at a tertiary care facility that has the capability to prevent and treat intracranial hypertension. Survivors of Reye's syndrome may have subtle neuropsychologic deficits but generally recover very well considering the gravity of the disease.