Adolescent problem gambling is a growing cultural concern and this paper reviews the various research findings and treatment options that are available. Scientists have discovered a number of biological factors that may contribute to the development of adolescent gambling, including specific brain states, neurochemical levels, physiological arousal tendencies, and genetic predispositions. Additionally, a number of psychological processes have been revealed, including the need to escape from psychological stress, the possession of certain cognitive fallacies, and the construction of incorrect rules about the gambling event itself. Effective treatment can be developed through the incorporation of empirically-based research into the clinical approach. Current treatment options include pharmaceutical prescriptions, changing cultural practices, and the delivery of psychodynamic, cognitive, and behavioral therapy models. An analysis of the gap between science and practice is described, and possible solutions to bridge this gap are provided.