The historic development of the attention deficit hyperactivity disorder (ADHD) construct is, in many cases, paralleled by research questions addressed with the continuous performance test (CPT). This task, the use of which dates back to the 1950s for the diagnosis of brain damage, requires responding to rare targets in a sequence of stimuli during prolonged assessment. In our review, we illustrate how the CPT was and still is used for the assessment of sustained attention and impulsivity as core features of ADHD. In addition to impaired performance at the neuropsychological level, the CPT also taps underlying brain activity that can be registered by neuroimaging techniques such as fMRI and EEG. The latter allows more detailed operationalization of ADHD theories, and reveals impairments at different stages of information processing. The CPT has also been applied for treatment evaluation. Recently, distinct genetic effects on preparation and response control or impulsivity were detected using the CPT. As such, the task remains a valuable tool for further investigations of genetic and environmental factors of ADHD.