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.