Conversation analysis (CA) is a paradigm for studying social interaction, investigating talk in its sequential context. The concept of adjacency (the relationship between two turns uttered by different speakers one after the other) is a powerful resource for participants to make sense of what each speaker is doing, both through talk and its absence. This concept enables us to pinpoint the relevant absence of talk of a specific kind. Drawing on three key conversation analytic tools – sequence organization, preference organization and turn taking – this chapter demonstrates how CA can be used to get a handle on the"unsaid." We present a case study from a neurology consultation in which an adult patient’s mother and neurologist work to process their contrasting diagnostic agendas. We demonstrate how CA can reveal (1) what is relevantly absent in a sequence of talk; (2) the unsaid in what is articulated, and (3) the (often subtle) silencing of another through particular interactional "moves." We show that the underlying conflict seldom rises to the surface of the interaction; each speaker attempts to maintain social bonds while s advancing their own objectives.