Examines the relation between depression, self-esteem, sex, and age to determine if the previously reported associations between these variables in nonreferred samples remain consistent in a sample of clinically referred patients. Two hundred thirty-six participants between the ages of 6 and 17 years were included. All were consecutive referrals to an outpatient child and adolescent mood disorders program. Eighty-four percent met the criteria for at least 1 depressive disorder from the third and revised edition of the Diagnostic and Statistical Manual of Mental Disorders (major depressive disorder, dysthymia, both, depression NOS, or adjustment disorder with depressive mood). In keeping with previous reports, the data indicate an inverse relation between age and self-esteem and an even stronger inverse relation between depression and self-esteem. However, there was no evidence for a sex difference for self-esteem, alone or interactively with age. The implications of these findings in relation to the importance of self-esteem in depressed youth are discussed.