Behavioural manifestations of conduct disorder (CD) among children and adolescents are one of the most common referrals to community psychiatrists. Patients with CD are difficult to treat. The patterns of maladaptive behaviours they exhibit are diverse and can vary as a function of age and gender. Although different pharmacological interventions have been reported as potentially promising options in the treatment of CD, no medication has yet received a formal approval from the licensure authorities, either in the US or Europe. This article reviews efficacy results and associated adverse effects from selected clinical trials that have the strongest outcome evidence for the treatment of CD in children and adolescents. Critical issues in the effectiveness of the evidence-based pharmacotherapy for CD are raised and future directions of the psychopharmacology of CD are examined.