Attention-deficit hyperactivity disorder, characterized by poor sustained attention, diminished impulse control and excessive physical activity, is found in most cultures and most countries. However, diagnostic terminology and management vary from centre to centre. Pharmacotherapy in conjunction with individual and family therapy is generally accepted as the most effective treatment, while psychostimulants are the drug of choice. The results of clinical studies with indications, contraindications and side-effects are reviewed. The use of alternative pharmacotherapy for those who do not respond to treatment and long term therapy is discussed. The need for careful diagnosis and patient management is emphasized.