BACKGROUND: Although griseofulvin is considered the standard treatment of tinea capitis, alternatives are being investigated in hopes of identifying more rapid and better cure rates. OBJECTIVE: Our purpose was to determine the efficacy of itraconazole as therapy for tinea capitis. METHODS: An open label study was performed on three patients who did not respond to or could not tolerate griseofulvin therapy. RESULTS: A 30-day course of 100 mg of itraconazole daily resulted in clinical and mycologic cure in all three patients; no side effects were reported. CONCLUSION: Although these results need to be confirmed by larger, controlled trials, it appears that itraconazole offers a viable alternative to griseofulvin for the treatment of children with tinea capitis.