Inappropriate sexual behaviors are common in children and youth with autism spectrum disorder that could lead to major distress in the patient and caregivers and sometimes could lead to the patient's expulsion from a social environment. When educational and behavioral intervention failed in reducing such behaviors, pharmacological management would be necessary. We presented here a clinical vignette of treatment of inappropriate sexual behaviors in an adolescent boy with autistic disorder. We further made a review of the literature on its pharmacological management. Our review revealed very limited documentation with only some cases studies that have reported successful treatment by several medications. More controlled studies are needed.