Serotonergic abnormalities have been reported in both autism and epilepsy. This association may provide insights into underlying mechanisms of these disorders because serotonin plays an important neurotrophic role during brain development-and there is evidence for abnormal cortical development in both autism and some forms of epilepsy. This review explores the hypothesis that an early disturbance in the serotonin system affects cortical development and the development of thalamocortical innervation, and is a potential mechanism, common to autism and pediatric epilepsies associated with cortical dysplasia. An argument is made that cortical malformation leads to abnormalities of thalamocortical connectivity, and that serotonin plays a critical role in this process. Finally, a role for altered metabolism of the serotonin precursur, tryptophan, in both epilepsy and autism is discussed. Key Words: serotonin; autism; epilepsy; tryptophan; cortical development; kynurenine E pilepsy is more common among autistic children than in the general population; conversely, autism (or milder pervasive developmental disorders) is more common in epileptic children than in the general population. There is evidence for abnormalities of the neurotransmitter serotonin in both epilepsy and autism. The role of serotonin in brain development is briefly reviewed here and then the evidence considered for a role of an altered serotonin system in these developmental disorders. We hypothesize that serotonergic abnormalities during prenatal and early postnatal development may lead to changes in thalamocortical connectivity, which results in a predisposition for autism and epilepsy. In addition, we discuss the involvement of aberrant metabolism of tryptophan-the metabolic precursor of serotonin-as a potential mechanism for alterations in serotonin availability.