The results of a double blind, placebo-controlled study of the effects of imipramine among 35 school phobic children between the ages of 6 to 14 are reported. The children and families were given a multidiscipline treatment program concurrently with imipramine or placebo treatment. Imipramine, over a 6-week period, was found to be significantly superior to placebo in inducing school return and in global therapeutic efficacy. Doses of medication ranged from 100 to 200 mg/day after 6 weeks of treatment.It was found that imipramine effects could not be detected after 3 weeks of therapy but were clearly present after 6 weeks. Of 10 items rated by the psychiatrists at baseline and after 6 weeks of treatment, 4 items which reflect the severity of the child's phobic behavior, the child's venturesomeness from the mother, physical symptoms while going to school, and fear of going to school were significantly improved by imipramine treatment.Among 10 items rated by mothers, only 1 item reflecting depressive mood showed a significant drug effect. On the whole, side effects were not significant, and only one child required dosage alteration due to orthostatic hypotension.The diagnostic characteristics of this population are discussed. Further, the relevance of the findings to theories of school phobia is examined.