The data generated by the pilot study showed that most of the juvenile crack dealers came from chaotic, dysfunctional families. Many of their mothers were unwed teenagers who abused drug and/or alcohol when they were pregnant. As a group the juveniles showed greater neuropsychological impairment and used more immature reasoning and primitive defense mechanisms compared with a group of non-crack-dealing delinquents. They relied heavily on egocentric and concrete reasoning, denial, and wishful thinking; however, most striking was their inability to recognize and describe feeling states in themselves and in others. This article advances the hypothesis that these clinical findings can be best understood as a failure in the development of empathy in the crack-dealing adolescents. This in turn prevented them from developing behaviors based on an awareness of their own emotional states and the feelings of others. The author reviews characteristics of the normal development of emotional awareness and empathy, followed by a discussion of how biological and familial-social factors early in the lives of these adolescents put them at risk for not developing adequate awareness of emotional experiences in themselves and others. The author suggests that the proposed hypothesis be tested by further clinical studies of adolescents who have already become crack dealers and of mother-infant pairs followed into adolescence. 15 references