Dr Russell J. Blattner, first recognized for his research in which he identified the cause of St. Louis encephalitis, was the first Physician-in-Chief of Texas Children's Hospital (TCH) in Houston, Texas. He played a primary role in establishing TCH, which has since become a world-class children's hospital. He also was the first Chairman of the Department of Pediatrics at Baylor College of Medicine (BCM) and was instrumental in initiating the department, which started with only Blattner and his one research assistant and is today one of the largest in the country. Today the 2 institutions enjoy a strong bond, which Blattner also was responsible for initiating. In addition to the administrative challenges he faced in his 30-year tenure at BCM and TCH, Blattner also was called on to confront racial prejudices of the South and to deal with epidemics and the ensuing sensationalized media coverage. He also developed close relationships with community leaders, faculty and administrative personnel, and members of the Junior League and the TCH Women's Auxiliary, the last 2 of which played key roles in the early years of TCH, as they continue to do today. This article focuses particularly on his role in the establishment and initial development of the Department of Pediatrics at BCM and TCH. Copyright © 2000 by W.B. Saunders Company