Depression is a common disorder of childhood and adolescence for which effective interventions exist. Primary care physicians should be familiar with its essential features to ensure that their patients do not suffer needlessly from this potentially devastating, even fatal disorder. Clinical signs and symptoms of depression typically are not difficult to elicit, but patients and families may fail to volunteer them unless asked. A growing body of evidence exists to guide clinicians in their choice of treatment interventions. Treatment response to studied interventions is high, although recurrence is common. Consultation with a child and adolescent psychiatrist is advisable in complicated cases or severe presentations, especially when patients are suicidal or threatening to harm others.