Tricyclic antidepressants have been used in the treatment of certain childhood disorders for more than 20 years, and indications for their use in the pediatric population are increasing. Research supports the use of tricyclics for preadolescent children as adjunctive therapy for major depression, attention deficit hyperactivity disorder, enuresis, tic disorders, anxiety disorders and eating disorders. The range of indications and effects of tricyclics in the treatment of children, and issues related to management by health care providers are discussed in this article.