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Clinical data from the analysis of a male underwear fetishist are presented to support the thesis that this form of fetishism is linked with a nuclear conflict of the male child in the preoedipal period—the unresolved wish to bear a child. This wish is but one of the many strivings of the boy at this age to ward off separation and separateness from the mother through being like her in every way, and has little genital significance, although it may subsequently re-enforce a similar wish of a negative Oedipal nature related to pssive-feminine feelings toward the father. In the course of normal development the boy does not change either his love object or his sex organ as he makes the transition to the Oedipal phase. He must, however, change his attitude toward his object. He must move from the security of identification and oneness with the mother to active, competent separateness and male (phallic) strivings. If this transition proves too difficult, pathological defenses may result, especially in the form of an increased maintenance of the primary identification and archaic aggressiveness. In the case presented, the core of the difficulty lay in the patient's persistent infantile fears of separation from the mother who had borne him by Caesarian section, fears which gave impetus to his preoedipal fixation upon her. Part of his identification with her was the wish to bear a child so as to be one with her in her power and achievement, a wish countered with dread, pathological defenses, and efforts at sublimation. His underwear fetishism, as an outgrowth of an inordinate attachment to a transitional object and the wish for a covering to protect the entire body from change envisioned at the level of body disintegration, served primarily as a solution for the dreaded early wish to have a child, and secondarily as a device to alleviate the conflicts of the later phallic period. In this case, as in other instances of perversion, the interrelation of preoedipal and