During the summer of 1994 we reviewed the demographic and clinical features of the 58 children and adolescents referred to a chronic fatigue syndrome program since its inception in 1990. The 58 patients were mean age 14.6 years(50% 7-14 years, 50% 15-21 years), 71% female, 94% white, and ill a mean of 11.25 months (50% 1-6 months, 50% 7-36 months) prior to presentation. Parents were predominantly middle class (Hollingshead scores of father's occupation: 22% upper, 58% middle, 20% lower) and 76% lived with both parents. School performance was considered excellent or good in 70% prior to illness, and 50% at first visit; school attendance was regular in 73% prior to illness but had decreased to 14%. At presentation 42% reported excellent/good relationships with friends, 38% “average”, and 20% few/no relationships; 30% still continued most/some activities with friends, 22%“occasionally”, and 48% rare/no activities. Sixty percent of patients reported an acute onset of illness and 60% a history of allergies. Most commonly reported symptoms and findings included fatigue (100%), headache(74%), sore throat (59%), abdominal pain (48%), fever (36%), impaired cognition (33%), myalgia (31%), diarrhea (29%), adenopathy (29%), anorexia(28%), nausea/vomiting (26%), congestion (22%), dizziness (19%), and arthalgia(17%). Trouble waking was reported by 86%; difficulty falling asleep by 50%; 69% reported sleeping ≥ 10 hours per day; and 44% took daily naps. Few physical abnormalities were noted: mildly inflamed pharynx (36%), subjective sinus tenderness (12%), shoddy cervical adenopathy (10%). Laboratory tests were non-diagnostic. No difference in clinical characteristics were noted based on age, sex, length, or acute onset of illness. These data demonstrate a wide variety of clinical and demographic characteristics in this population referred for evaluation of chronic fatigue.