There is little research on psychosocial factors and insulin pump use in adolescents. The purpose of the present study was to use qualitative and quantitative methods to explore psychosocial issues related to insulin pump use [continuous subcutaneous insulin infusion (CSII)] in youth. Eighteen early adolescents and their parents were interviewed about the experience of using an insulin pump, and transcripts were content-analyzed. In general, interviewees reported modest improvements in glycemic control with initiation of CSII. Teens and parents did, however, report high levels of satisfaction with pump therapy and increased adolescent responsibility for the diabetes regimen. In addition, pump users reported few issues related to body image, appearance, or social aspects of pump dependency. Chief concerns were related to the demands of initiating pump therapy, pump alarms and malfunctions, potential for regimen non-compliance with CSII, and school-related issues. Pump use is not associated with social difficulties, and, in general, youths and their parents report high satisfaction with CSII.