This article provides a review of various psychotropic agents employed for children and adolescents with externalizing disorders. With the exception of the stimulants, clinical use of psychotropic medications for children with externalizing disorders far exceeds the available empirical literature. Further, there are insufficient data pertaining to the safety and efficacy of most psychotropics. Studies that examine the combination of psychotherapy and pharmacotherapy are also reviewed, with particular attention to the National Institutes of Health Multimodal Treatment Study for Children with Attention-Deficit/Hyperactivity Disorder. Recommendations are made for future multimodal studies all externalizing disorders and with all psychotropics in addition to the stimulants. Future goals for research over the next decade include studies that examine treatment acceptability, adherence and and satisfaction, adherence with various psychotropic agents, and ecologically valid investigations of pharmacotherapies for both symptom reduction and enhancement of functional behaviors among children and adolescents with externalizing behavioral problems.