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Treatment of the aggressive child or adolescent must be part of a comprehensive, multidimensional project that can then be supplemented by drug support. The aim of this article is to give an update on the latest pharmacotherapeutic data in order to assist prescription. First-generation antipsychotics remain a viable option from the age of three. However, even if marketing authorization is available for indications of aggressive symptoms, it would be preferable to use atypical antipsychotics. Risperidone is the molecule with the highest level of evidence, in the absence of Attention Deficit Hyperactivity Disorder (ADHD). When aggressiveness is catalyzed by ADHD, psychostimulants should be prescribed. Methylphenidate has indeed shown its effectiveness on both ADHD and the aggressiveness that can be associated with it. Serotonin reuptake inhibitors and lithium should only be prescribed as an etiological treatment of the disruptive behavior symptoms of depressive or manic disorders. Beta-blockers have not been the subject of recent studies for this indication, despite valuable preliminary studies. Alpha2 adrenergic antagonists (clonidine, atomoxetine), used in America, may be prescribed as a second-line treatment for aggressiveness in ADHD. The proposed treatments will only be used for a short period of time.