The clinician prescribing antipsychotic medication must balance symptom control with management of health-threatening side effects. This Clinical Case Conference reviews treatment of a young adolescent with schizophrenia, and brain imaging studies of children, adolescents, and young adults treated with antipsychotic medications. The presenters examine imaging studies of the effects of antipsychotic medications on the developing brain; and investigate medication side effects and interventions to ameliorate them. Four speakers from three institutions share their experience in the phenomenology, diagnosis, and treatment challenges presented by childhood onset schizophrenia.