Attention deficit hyperactivity disorder (ADHD) has become the most commonly diagnosed psychiatric disorder among school-age children. For more than half a century, physicians have prescribed medications to help manage behaviors such as hyperactivity, impulsivity, and inattention. Today, there is a growing consensus that ADHD is a biologically based disorder, and medication is now considered the first line treatment. This article discusses the therapeutic benefits and potential side effects of psychotropic medications commonly prescribed to youth with ADHD, academic and behavioral benefits associated with medication therapy, recommendations for monitoring medication efficacy, legal considerations, and the importance of establishing school medication policies. (Contains 4 tables.)