The aim of this study was to investigate MAOA gene variants in bipolar disorder by using a family-based association approach. The first sample included 331 nuclear families from Western and Central Canada with at least 1 offspring affected with bipolar disorder comprising a total of 1,044 individuals. All subjects were genotyped for MAOA-941T > G and -uVNTR gene variants using PCR techniques. Haplotype TDT was statistically significant (LRS = 12.17; df = 3; P = 0.0068; permutation global significance = 0.00098), with the T-4 haplotype significantly associated with bipolar disorder (OR = 1.63, 95% CI = 1.11-2.37). Single marker analysis evidenced a borderline association for MAOA-941T > G (P = 0.04), but not for the uVNTR. Pooling the Canadian sample with a second previously reported Italian sample genotyped for the uVNTR variant, negative results were obtained as well. No different results were detected when analyzing female subjects separately. In conclusion, our family-based association study gives mild but further support of the involvement of MAOA variants in bipolar disorder.