Munchausen by proxy (MBP) refers to a specific form of maltreatment by individuals with a specific psychiatric diagnosis. The maltreatment can include exaggeration, fabrication, simulation, and/or induction of physical or psychiatric illness in another. An objective clinical evaluation of suspected illness falsification requires reliance on direct observations, collateral information, and on closely monitored medical tests.  Unlike the traditional medical information gathering decision-making process, the symptoms and medical history reported by the suspected caregiver must be considered potentially inaccurate. Diagnosis of MBP is a complex, and at times lengthy, process that requires multiple sources of information in addition to clinical interviews. Prognosis is important in decision-making related to both adult treatment and child safety and care. Although difficult, psychotherapy can be effective in select cases, especially when the parent has admitted the abusive behaviors and demonstrated empathy for the victims. Through case presentations and personal experiences treating MBP, attendees increase their knowledge of the complex issues involved in diagnosis and treatment, and are more aware of the ways MBP may present.