This chapter reviews the diagnostic features of pediatric bipolar disorder (BPD) patients, co-morbidity, and the evidence for various medications, including complementary treatments, and offers a treatment algorithm. Co-morbid disorders are the rule rather than the exception among children and adolescents with BPD. Lithium is the only mood stabilizer approved by the United States Food and Drug Administration (FDA) for use in the treatment of mania in adolescents. Valproic acid (VPA) is a chemical compound that has found clinical use as an anticonvulsant and mood stabilizer. Treatment of bipolar depression (BD) can be complicated because of the often necessary use of combinations of medications, including antidepressants, that may induce mania, hypomania, or rapid cycling. It is important for clinicians to be familiar with complementary and alternative medicine (CAM) and integrative therapies for bipolar disorder, as parents may well be using them for their affected children, with or without informing the clinician.