Background: Significant pharmacotherapy disparities exist among children from ethnic minorities with ADHD. Objective: The purpose of this review is to synthesize existing evidence on African American caregiver medication decision making (MDM) for children with ADHD. Method: Databases queried for this review included the Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsychINFO, PubMed, and Education Resources Information Center (ERIC). Information regarding the unique culturally specific barriers and supports to MDM were examined through the relevant literature search. Results: Fourteen articles were included in this review (seven observational studies, four qualitative studies, three mixed methods studies). Three main themes were identified which include (a) fundamental perspectives of ADHD, and cultural norms for child behavior; (b) the impact of fundamental perspectives on MDM in ADHD; and (c) ADHD diagnosis and treatment as forms of social control. Conclusion: Evidence-based recommendations for clinicians are provided, along with direction for future research.