Objectives: Psychosis starting in childhood and adolescence are neurodevelopmental disorders with pervasive course, challenging diagnosis and poorer prognosis than adult-onset psychosis. Methods: This presentation will review recent advances on early-onset psychotic disorders, focusing on those aspects with special interest for developing therapeutic interventions. Results: Children and adolescents represent a unique opportunity for the study of psychosis, before factors such as psychotropic treatments or illicit drugs, comorbid conditions or relapses may impact illness progression. Mounting evidence suggests the presence of developmental impairment in early-onset psychosis. Premorbid social impairment, childhood trauma and abuse, earlier onset of cannabis use, or childhood psychiatric disorders all increase the risk of early psychosis. Psychosis identification in children and adolescents is challenging, what may have impact on longer duration of untreated illness, one of the main predictors of functional and clinical deterioration, in this population. Study of intermediate mechanisms such as inflammation has also been critical in early-onset psychosis. Recent studies suggest the presence of a sustained higher inflammatory and oxido/nitrosative status of cells in adolescent-onset than in adult-onset psychosis, opening the window for developing new therapeutic interventions. Conclusion: Early-onset psychosis represents a challenging population diagnostic and treatment wise. A parsimonious approach aimed at shortening the gap between illness-onset and treatment implementation and also at early detection of risk states and implementation of developmentally sensitive interventions on risk populations is warranted.