The use of oxandrolone, an analog of testosterone possessing only 5% of testosterone’s virilizing androgenic effects, enhances anabolism of muscle protein by improving the efficiency of protein synthesis in severely burned children. Oxandrolone administration decreases loss of body weight and improves healing of the donor site wound. In a large clinical trial by our group, 0.1 mg/kg oxandrolone administered twice daily reduced length of the acute hospitalization, sustained LBM, and improved liver protein synthesis. Severely burned pediatric patients receiving oxandrolone for 1 year experienced improved growth, decreased cardiac work, and improved muscle strength. Oxandrolone treatment also improved lung function at rest and during exercise in this patient population. These improvements were maintained for up to 4 years after treatment had ended. The benefits of oxandrolone administration after burn injury were further enhanced when the treatment period was increased from 1 to 2 years.