Somatization, the physical expression of psychological distress, is a prevalent and important problem. It is seen in a wide variety of clinical settings and represents a significant evaluation and management dilemma. The burden to the patient--coupled with the consequential economic and social costs--can be substantial. As a result, the identification and appropriate management of these patients and their often-challenging symptoms is imperative. The following review attempts to summarize the significant body of work committed to the concept of somatization in the medical, surgical, and psychiatric literature. Articles were found through a Medline Search. The search was performed utilizing the terms "somatoform disorders," "somatization," "somatization disorder," "alexithymia," and "medically unexplained symptom" for January 1966 through May 2004. Appropriate referenced articles and text were also identified and incorporated.