The etiology of somatic symtomatology in children is occasionally difficult to ascertain in spite of vigorous investigative efforts. This paper explores a case of illness in a child in which psychological and somatic factors in both parent and child interact in a complex, pathological way. The case is one of Munchausen syndrome by proxy which is unique in its presentation, in that the child's mother has Munchausen syndrome. A literature review of Munchausen syndrome and Munchausen syndrome by proxy is included.