During the past two decades psychopharmacologists have made considerable strides in establishing the safety and efficacy of psychotropic drug therapy for childhood behavior disorders. Most of the research has focused on children with disruptive behavior disorders, autism, or mental retardation, but more recently other disorders such as depression, obsessive compulsive disorder, separation anxiety (school refusal), and Tourette syndrome are also receiving attention. Psychopharmacotherapy has often been a matter of controversy, with most issues pertaining to either the appropriateness of medication (e.g., rationales for treatment, alternative interventions, toxicity, iatrogenic effects) or inadequacies of clinical management (e.g., availability of services, drug assessment procedures, limitations of research). This article presents a brief overview of the safety and efficacy of psychotropic drugs and the issues associated with their use in clinical settings.