Religious or Spiritual Problem is a new diagnostic category (Code V62.89) in the 1994 Diagnostic and Statistical Manual of Mental Disorders. Although the acceptance of this new category was based on a proposal documenting the extensive literature on the frequent occurrence of religious and spiritual issues in clinical practice, the impetus for the proposal came from transpersonal clinicians whose initial focus was on spiritual emergencies-forms of distress associated with spiritual practices and experiences. The proposal grew out of the work of the Spiritual Emergence Network to increase the competence of mental health professionals in sensitivity to such spiritual issues. This article describes the rationale for this new category, the history of the proposal, transpersonal perspectives on spiritual emergency, types of religious and spiritual problems, differential diagnostic issues, psychotherapeutic approaches, and the likely increase in number of persons seeking therapy for spiritual problems. It also presents the preliminary findings from a database of religious and spiritual problems.