The special position of 'first dreams' was originally discussed by Stekel and by Freud in 1911, later by Jung in 1931. Since then developments in structural theory and in ego psychology have added a new dimension to dream theory and to the practice of dream interpretation. The question is whether or not special diagnostic and prognostic significance should be attached to the initial dream, as compared with dreams in later phases of the treatment. In the first part of his paper, Schultz defines the main concepts and reviews the literature pertaining to the initial dream. The second part is devoted to the author's own investigation of the initial dream, illustrated with clinical case material from the Heidelberg Psychosomatic Clinic.