To evaluate the feasibility and efficacy of behavioral relaxation therapy as treatment for Tourette syndrome, 23 patients were recruited from a university-based pediatric Tourette syndrome referral clinic. Individuals were randomized and stratified according to initial tic severity and the presence of attention-deficit hyperactivity disorder into either relaxation therapy or a minimal therapy (control) group. Sixteen patients, mean age 11.8 years (S.D. 2.8 years), completed the 3-month study, which included weekly, hour-long, individual training sessions for 6 weeks. Individuals (n = 7) in the relaxation therapy group demonstrated a significantly increased ability to relax, compared with the minimal therapy (awareness and quiet time training) group. At 6 weeks, tic findings, based on five established tic severity scales, revealed greater improvement in the relaxation treatment group, but values failed to reach statistical significance. No difference between therapy groups was apparent at the 3-month evaluation. The acquired ability to relax did not significantly affect behavioral measures on the Child Behavioral Checklist. On the basis of this pilot study, relaxation therapy appears to have a limited role in the treatment of tics in Tourette syndrome.