Aggression in children and adolescents is a serious problem and is associated with various psychiatric disorders, not just conduct and oppositional defiant disorders, but in fact, most psychiatric disorders. Currently, while a growing base of data supports an important role for pharmacologic treatments in managing aggression, studies have also shown that psychosocial therapy in conjunction with medication may be more effective in treating aggression than medication alone in many patients. According to recently published treatment guidelines on the management of aggression, psychosocial approaches should always be implemented first, with pharmacotherapy added later if necessary. This article details the risk factors and protective factors associated with aggression in children and adolescents, describes the evidence base for the use of psychosocial therapy for the management of aggression, and discusses various psychosocial therapy approaches that may be effective in treating aggressive children and adolescents.