The relationship between syllabic structure and segmental development was examined longitudinally in a child with a severe phonological disorder. Six speech samples were collected over a 4-year period (3:5 to 7:3). Analyses revealed gradual increases in the complexity and diversity of the syllable structures produced, and positional preferences for sounds within these forms. With a strong preference for [d] and [n] at the beginning of syllables, other consonants appeared first at the end of syllables. Implications for clinical management of phonological disorders include the need to consider both structural position and structural complexity in assessing segmental skills and in choosing target words for intervention.