We followed 53 children with chronic hepatitis C for more than 3 years. Spontaneous remission occurred only 3 (6%) in whom the serum titer of HCV-RNA was low. We considered interferon (IFN) should be adopted in all children with chronic hepatitis C but those who expected to be remitted spontaneously. We evaluated the effect of IFN therapy on 32 children and investigated factors that may influence the outcome of the treatment. A complete response was obtained in 13 children (41%). IFN was well tolerated.