Postpartum psychosis is a rare but serious psychiatric illness that follows delivery. Although controversy continues to surround its diagnostic status, it is generally considered an episode of bipolar disorder with accompanying psychotic features. The consequences of untreated postpartum psychosis can be serious due to the associated risk of suicide and infanticide; however, its close temporal association with childbirth should provide an opportunity to undertake prophylactic measures in women at risk for developing postpartum psychosis. This article reviews the literature concerning acute and prophylactic pharmacological treatment and suggests a comprehensive approach for management of postpartum psychosis.