The curative potential of mAbs in the treatment of patients with metastatic neuroblastoma is increasingly evident. The idiotype network appears to represent one component of a complex mechanism for success with mAb-based immunotherapy. Ongoing strategies to modify or reconstruct mAbs, to engage them with cytokines, or to unite them with T cells open new avenues for harnessing the unique forces of the immune system against some of the most deadly pediatric cancers.