Behavioral and psychological symptoms of dementia (BPSD) are common among patients with dementia. BPSD have significant implications on outcomes for patients and caregivers. Available literature for pharmacological approaches to BPSD is sparse and at times inconsistent. There are no FDA-approved medications for the management of BPSD, and the use of available medications is associated with significant adverse effects among aged populations with dementia. This review outlines the assessment of BPSD, discusses general principles of management, and examines current evidence for non-pharmacologic and pharmacologic treatment strategies as well as associated risks.