Abstract: Early onset schizophrenia (EOS) describes onset of the first episode of psychosis before age 18 years. Such an earlier onset of symptoms is often associated with a severe and chronic course of the illness, a poorer prognosis and a potentially significant negative impact on recovery and rehabilitation. A recent emphasis on early intervention by utilizing the advances in neurobiological and psychosocial domains along with psychopharmacological effectiveness research in managing this chronic psychotic disorder is paving the way for a more rigorous study of this chronic disabling disorder. This chapter reviews recent literature on diagnostic assessment and management of schizophrenia when it strikes during formative years, and provides future directions for further research in the area.