During the past 50 years, the predominant etiologic agent of tinea capitis in the United States and in Western Europe has changed from Microsporum audouinii to Trichophyton tonsurans. This is thought to be due in part to the sensitivity of M audouinii to griseofulvin treatment and, in part, due to the importing of T tonsurans by people emigrating from geographic areas where that vector had been the prominent cause of tinea capitis. With these changes, prospects for newer therapies with the novel antimycotic agents itraconazole, fluconazole, and terbinafine are reviewed. (J Am Acad Dermatol 2000;42:1-20.)At the conclusion of this learning activity, participants should be familiar with the history, epidemiology, and current knowledge of tinea capitis, as well as the newer antifungal agents (ie, itraconazole, fluconazole, and terbinafine) to treat this infection.