OBJECTIVE: To review evidence-based behavioral and pharmacologic therapies in the treatment of pathologic gambling (PG). METHODS: Available literature was reviewed and results of behavioral and pharmacologic treatment studies were summarized and evaluated. RESULTS: Multiple behavioral and pharmacologic therapies have been studied in the treatment of PG. Compared with no treatment, several types of behavioral treatments seem beneficial in the treatment of PG. For those who attend, self-help programs seem helpful. Among pharmacotherapies, selective serotonin reuptake inhibitors have shown mixed results whereas opioid antagonists have shown more consistent efficacy, although fewer studies have been performed with these agents. Other pharmacotherapies have shown preliminary positive results. SUMMARY: Multiple behavioral and pharmacologic therapies have been studied and show promise in the treatment of PG. Larger studies with longer follow-up are needed. Treatments targeting specific subpopulations of people with PG will likely refine and enhance efficacies of specific therapies, and standardized outcome measures should improve comparisons of interventions across studies.