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Subsequent to Dr. Bruno Bettelheim's death in 1990, there appears to have been a renewed interest in his writings about seriously disturbed youth. The critical review which follows assumes that many of Bettelheim's contributions to the elaboration of milieu treatment remain with us even today as influential parts of both the residential and inpatient psychiatric care of children and adolescents in the United States and abroad. In an attempt to distill and clarify certain areas of Dr. Bettelheim's clinical legacy, the present study surveys a selected number of Bruno Bettelheim's clinical articles on milieu therapy, childhood schizophrenia, and autism. In addition, it examines his understanding of certain basic psychoanalytic concepts. Of these clinical topics, the major focus of this paper is clearly upon Bettelheim's writings about childhood autism and especially upon the formulations he presented in The Empty Fortress (Bettelheim, 1967), which represents the culmination and highest form and elaborative evolvement of his theories about childhood schizophrenia and autism. Following these reflections, some of the major contributions of Dr. Bettelheim's clinical legacy are highlighted, with special regard to certain hypotheses associated with his study of the nature of schizophrenia and infantile autism.