The purpose of this chapter is to review what is currently known about the conceptualization and assessment of psychopathy in childhood, and to offer perspective on where investigative work in this area can proceed from here using the aforementioned questions as a guide. In the service of this broad goal, the chapter is organized around five specific aims. First, we consider how psychopathy relates to conditions listed in the “Disruptive Behavior Disorders” section of DSM-5, devoting special attention to the diagnosis of conduct disorder with limited prosocial emotions (CD+LPE) as a means to capture child psychopathy. Second, we review findings from developmental studies testing the extent to which psychopathic tendencies can be identified reliably and effectively, in terms of predicting meaningful outcomes, at early ages. Third, to further address the question of how applicable the diagnosis is to youth, we summarize existing evidence regarding the structural properties and criterion-related validity of differing established measures of child/adolescent psychopathy. Fourth, we review etiological theories and relevant research findings, including data from neuroscience. Fifth, we outline directions for future research, with an emphasis on ways to improve investigative approaches and interpretability of findings in this crucial area of study. In this latter section of the chapter, we also address issues such as the need for continuing research directed at clarifying relations between child psychopathy and the childhood diagnoses in the DSM.