I 1928 Freud published an essay about the pathological gambling of Fyodor Dostoyevsky, the Russian author who wrote a novel called The Gambler based on his personal experience. However, not until 1980 was pathological gambling acknowledged by the American Psychiatric Association as a psychiatric disorder of impulse control. The classification of pathological gambling as a psychiatric disorder was followed by the development of uniform diagnostic criteria, a valid, reliable screening tool—the South Oaks Gambling Screen (SOGS) (1)—and preliminary neurobiological studies that implicated serotonergic dysfunction in pathological gambling (2). However, few psychiatrists have had substantial experience in the prevention, assessment, and treatment of pathological gambling. Moreover, despite rapid increases in gambling opportunities in the last decade, public health, clinical, and social implications of gambling behavior have been understudied, particularly among adolescents. We would like to argue that the current lack of knowledge about and failure to respond to adolescent gambling behavior is similar to the situation that existed 30 years ago in the area of another addiction, substance abuse. We fear that failure to draw attention to the needs of adolescents at high risk for problem and pathological gambling may result in an increase in the number of pathological gamblers in the next generation. Such an increase would be accompanied by emotional and financial damage to these individuals and their families and by legal and financial costs to the community.