The replacement child syndrome has been discussed from the vantage point of parents who have attempted to undo their loss through replacement phenomena, or from the vantage point of the effects of being a replacement child on the children themselves. This article discusses the replacement child syndrome from a previously unreported perspective: A case is presented in which a woman whose sibling had died during adolescence experienced her own child, almost two decades later, as a replacement for the lost sibling. This process was facilitated by the oedipal meaning of her sibling, as well as by the interference in her family's ability to mourn the death of the child. The case illustrates the manner in which these conflicts were activated during the patient's pregnancy, and how they subsequently interfered in the developing mother-infant relationship prior to intervention.