Preliminary findings from a long-term, prospective, longitudinal, naturalistic treatment study of adults with social anxiety disorder (SAD) demonstrate that this illness has a chronic course and a greater adverse impact on social functioning than do depressive symptoms or chronic medical illnesses. Comorbid anxiety, depressive, and personality disorders are common in patients with SAD. Only 35% of patients with SAD recovered after 10 years of prospective follow-up. Whereas, the relapse rate, once recovery is achieved, is 34% during this 10-year follow-up. Treatment is underutilized in patients with SAD, and a long-term treatment approach may be needed to improve the likelihood of recovery from SAD.