Autism spectrum disorders (ASDs) are a complex group of neurodevelopmental conditions that develop in early childhood and involve a range of impairments in core areas of social interaction, communication, and restricted behavior and interests. Associated behavioral problems such as tantrums, aggression, and self-injury frequently compound the core deficits and can significantly reduce the efficacy of first-line therapeutic behavioral and educational interventions. Although the etiology remains unclear and curative treatments are not presently available, psychopharmacologic interventions can reduce the severity of some of the symptoms of ASDs. This article reviews the medications most frequently used in the treatment of ASDs, both U.S. Food and Drug Administration (FDA) approved and off-label, as well as the current evidence base on efficacy of these medications.