Neuropsychological, neuroimaging, and genetic studies have demonstrated the biological underpinnings of attention deficits hyperactivity disorder (ADHD). These studies have correlated deficits in executive functioning, response inhibition and planning with specific regions of the brain. The multimodal treatment study (MTA) study randomized participants to intensive behavioral therapy, pharmacotherapy with systematically delivered methylphenidate, a combination of the two, or standard community care. The American Academy of Child & Adolescent Psychiatry (AACAP) Practice Parameters for ADHD published in 2007 combine short- and long-term empirical evidence with expert opinion from pediatric mental health researchers and clinicians. A meta-analysis of atomoxetine and stimulant studies revealed a robust effect size for atomoxetine and the stimulants, both of which are currently approved by the food and drug administration (FDA) for the treatment of ADHD. In the interim, appropriate diagnosis, informed prescribing, clinical monitoring, and collaborative treatment planning can all help to optimize outcomes in ADHD management.