Munchausen syndrome by proxy is a form of child abuse in which a parent simulates or produces illness in a child for the purpose of engaging in a supportive relationship with a physician or other health care provider. The child suffers from the parent's actions and is subjected to significant morbidity due to extensive medical diagnostic procedures ordered by the unsuspecting physician. The purpose of this paper is to provide a better understanding of this disorder with respect to presentation, pathogenesis, and recognition.