Adolescents are a vulnerable patient population experiencing heightened social, academic, and emotional changes which can make them difficult to diagnose and treat. Providers are hesitant to first prescribe medication for adolescent ADHD due to fear of diversion and risk of substance use. However, untreated ADHD may have long-term adverse outcomes including a higher risk of other psychiatric disorders in adulthood, motor vehicle accidents and violations, and other psychiatric disorders later in life (Charach et al., J Am Acad Child Adolesc Psychiatry 50:9–21, 2011). In fact, treatment of ADHD can help reduce the risk of substance use (Wilens et al., Pediatrics 111:179–185, 2003). Moreover, treatment with medication has a proven response rate to help control the core symptoms of ADHD. Choice of medication and dosing may seem overwhelming due to the large number of formulations on the market. Cost and family preferences are also important to keep in mind when choosing treatment. This chapter will explore the different classes of medications and considerations for prescribing medications to treat ADHD.