The transition from childhood t o adulthood is a challenging period in the lives of youngsters with Down syndrome. In this paper, I provide a comprehensive overview of the transition period, including relevant biomedical, behavioral, educational, vocational, recreational, and other developmental issues. The specific medical concerns include weight gain, atlantoaxial instability, thyroid dysfunction, skin disorders, cardiac conditions, sleep apnea, and psychiatric disorders, all of which occur at increased frequency during the transition period. Of utmost importance is the preparation of young people with Down syndrome during their school years for the world of work and their optimal participation in community life. This gives rise to issues such as the development of healthy self-esteem, becoming increasingly more independent, and involvement in various leisure or recreational activities. The ultimate goal for people with Down syndrome who progress through a well-planned transition period is to live well-adjusted and happy adult lives. These individuals should be offered a status that observes their rights and privileges as full citizens in a democratic society and that, in a real sense, preserves their human dignity.