A 17-month-old girl had severe emaciation and complaint of nighttime wakefulness. The presence of marked wasting, hypotonia, psychomotor retardation, hirsutism, and breast hypertrophy suggested a diagnosis of leprechaunism. Prompt reversal of these features and marked acceleration of growth rate on hospitalization led to the correct diagnosis of emotional deprivation and short stature. These findings demonstrate that emotional deprivation may present with features of leprechaunism.