This study assessed change in the frequency of primary nocturnal enuresis as produced by either behavioral conditioning with a urine alarm, pharmacotherapy with imipramine hydrochloride, or assignment to a clinical waiting list. The study also investigated the effect of treatment method and outcome on subjects' level of emotional and behavioral adjustment. An attempt was made to identify pretreatment predictors of treatment outcome and premature withdrawal from the treatment program. The results indicated a significantly more effective outcome for the conditioning approach. Comparison of pre- and post-treatment measures of adjustment provided insufficient evidence to support the hypotheses that either change in the frequency of nighttime wetting or the method of treatment received would influence the subject's level of emotional and behavioral adjustment. The enuresis tolerance scale was found to be a highly significant predictor of early termination from conditioning treatment.