This paper reviews the presentation, clinical features. and management of early-onset bipolar disorder. A framework for the treatment is based upon a systematic, critical appraisal of the available literature. A multimodal approach is emphasised using individual and family psychoeducational interventions in conjunction with pharmacotherapy. The role of mood stabilisers--lithium--and the anticonvulsants--sodium valproate and carbamazepine is reviewed, alongside the treatments for depression in bipolar disorder and refractory mania.