Disruptive behavior disorders (DBDs) represent a spectrum of disorders, including conduct disorder and oppositional-defiant disorder. The atypical antipsychotic risperidone may be useful for the management of patients with DBDs. Clinical data on risperidone have demonstrated efficacy and satisfactory tolerability in improving angry, aggressive, self-injurious, and disruptive symptoms and behavior in children with pervasive developmental disorders and mood disorders. This paper reviews the results of recent studies that have evaluated the efficacy and safety of risperidone in the treatment of pediatric patients with DBDs. Because concerns have been raised regarding the safety of atypical antipsychotic treatment in pediatric patients, this paper further evaluates safety risks by presenting newly completed analyses of movement disorders, prolactin concentrations, body weight, and cognitive function data from short- and long-term studies in this patient population. A comprehensive review of all of the findings suggests that risperidone is an effective and well-tolerated treatment option for children and adolescents with DBDs. As with all antipsychotics, practitioners should monitor young patients' growth, weight, sexual maturation, and metabolic parameters.