MSBP is defined as "the deliberate production or feigning of physical or psychological signs or symptoms in a person who is under the individual's care." Typically, the victim is a young child, and the perpetrator is the victim's mother. The motivation for the perpetrator's behavior is presumed to be a psychological need to assume the sick role by proxy. Categories of perpetrators are "help seekers," who are mothers seeking help for a variety of reasons, more for themselves than their children; "active inducers," who induce dramatic symptoms of illness in a young child; and "doctor addicts," who are obsessed with obtaining medical treatment for nonexistent illness in their children. The "active inducers" are the most commonly described of the MSBP cases, because such cases involve the threat of harm and even death to the child. In the section on diagnosis in this paper a table outlines ways to confirm a diagnosis of MSBP. The section on legal outcomes advises that most often child-protection procedures are invoked, while prosecution is reserved for the most serious and dangerous cases. Regarding treatment, the author advises that success in therapy will depend on the individual dynamics of the patient, her willingness to acknowledge her fabricating behavior and its destructiveness, the responsiveness of other family members to the need for change in the family system, and the therapist's ability to work supportively with the patient without being deceived by her surface presentation. Clues to the diagnosis of MSBP are outlined.