The dramatic changes in medical science over the past 30 years have enabled the survival of children with severe chronic impairments and the development of a complicated system of specialized health care for them. The current health care system does not recognize the expertise or the primacy of the family in providing for the well-being of their children. Both professionals and parents acknowledge the challenge to organize the delivery of health care in a manner that supports the growth and development of the child and family. Family-centered care is a new philosophy of health care that places the family rather than the hospital and medical staff at the center of the health care delivery system. The eight essential components have been described. Parents remain the most knowledgeable and committed advocates for their children. Successful implementation of family-centered care for this nation's population of children with chronic illness and physical disability requires significant changes in the roles currently played by professionals and by parents, as well as major reforms in the policies and practices of the health care system.