Medical neglect is conceptualized as a situation in which a child's clear medical needs are not met. This relatively broad definition of medical neglect focuses on important unmet needs of children rather than on parental omissions in care. Several issues are relevant to conceptualizing medical neglect: actual versus potential harm, severity of harm, and frequency and chronicity of incidents or behavior. Medical neglect of children is frequently not detected or reported to child protective services, making the estimation of the incidence of medical neglect difficult. Nonetheless, estimates of child neglect in the United States in 1986 indicated 507,700 children were physically neglected, 203,000 were emotionally neglected, and 285,900 were educationally neglected. The etiology of medical neglect is examined in terms of parent and child characteristics, family interactions, the community setting, and society at large. Manifestations of medical neglect are noted, such as noncompliance with medical recommendations, failure or delay in seeking health care, religiously motivated medical neglect, and drug-exposed newborns. Certain principles of evaluation and intervention are offered that focus on harm caused by and severity of medical neglect, what contributes to neglectful situations, an interdisciplinary approach to the evaluation and management of medical neglect cases, the use of the least intrusive approach possible, the use of the family's natural and informal supports, reporting to child protective services, parental participation in interventions, and advocacy. 70 references, 1 note, and 2 tables