We applied an operational definition of neurotic depression to 185 hospitalized patients who met Feighner and DSM-III-R criteria for unipolar depression. Based on a systematic chart review, 37 patients met the criteria for neurotic depression. As a group, these patients differed from nonneurotics in symptoms, clinical course, outcome, and family history. The neurotic depressives were younger and more likely to identify precipitating factors. They were less likely to meet criteria for melancholia and to have delusions. They were more likely to be ill 3 years later and more likely to have familial alcoholism. These differences help to confirm the validity of the neurotic depression concept.