Although this chapter focuses on the disparities in evaluation, treatment, and school resource access for children with ADHD based on race, culture, and ethnic background, race is not biological. It is strictly a social construct based on arbitrary and discriminatory criteria that stems from a long history of prejudice toward people who have higher melanin pigmentation in their skin and/or whose primary language is not English. Thus, this chapter uses the term race to refer to the social hierarchy that favors those with lower melanin pigmentation over those with higher melanin pigmentation. This system of preference is frequently referred to as racism, and more specifically, medical racism when referring to health inequities. It is important to make this distinction—that race is not biological—because there is research that demonstrates laypeople and medical professionals alike continue to hold false beliefs of biological differences between races (e.g., “Black people have thicker skin,” “Whites have larger brains,” “Blacks have higher pain thresholds”) (Hoffman et al., Proc Natl Acad Sci U S A 113:4296–4301, 2016). Additional research has found that pediatricians are more likely to prescribe narcotic medication for pain (using clinical vignettes) for Whites and this likelihood increased as their pro-White implicit bias increased (Sabin and Greenwald, Am J Public Health 102:988–995, 2012). The growing body of research documenting health inequities and beliefs based on race, culture, and ethnic background in the social, public health, and medical literature over the past several decades is vast. It is therefore increasingly important to evaluate the impact of race, ethnicity, and cultural differences on ADHD diagnosis and treatment. The need to approach ADHD from a multifaceted perspective is further highlighted by known racial and ethnic disparities around ADHD. This chapter uses cultural humility and racial justice lenses to explore the following domains. First, general expectations for adolescence and factors leading to variations in expectations are explored. We then explore the intersection between racial, cultural, and ethnic diversity regarding diagnosis and treatment of ADHD from the perspective of parents, healthcare professionals, and educators. We provide suggestions for acknowledging and addressing differences in individual perspectives and larger systemic barriers as a means of mitigating diagnostic and therapeutic inequities. We also draw upon the American Academy of Pediatrics (AAP) Policy on “The Impact of Racism on Child and Adolescent Health” for strategies that pediatric clinicians can implement to address the disparities that exist based on the effects of racism (Trent et al., Pediatrics 144, 2019). The authors of this policy have expanded their recommendations for pediatric health professionals with active strategies that can be implemented to address the disparities in health caused by racism (Trent et al., Untangling the thread of racism. American Academy of Pediatrics, 2023).