Bipolar disorder has been shown to have a chronic course of illness, and children with this disorder are likely to need long-term treatment. Although limited data exist on the efficacy of long-term pharmacotherapy for pediatric bipolar disorder, 5 medications are approved as monotherapy for mixed or manic episodes and 2 are approved as adjunctive treatment. Clinicians should be vigilant in monitoring adverse events in children and adolescents taking psychotropic medications and should consider implementing psychotherapeutic interventions, which can improve youths’ symptomatic and functional outcomes.