OBJECTIVES: To perform a systematic review (SR) of literature and present the most current and up-to-date treatment recommendations issued by clinical practice guidelines (CPG) around the world, as well as those from SR of randomized controlled clinical trials (RCT) regarding BD-I therapy strategies. METHODS: A set of questions was formulated on BD-I regarding current treatment options (and their efficacy and safety), non-pharmaceutical options, which guidelines are available and what strategies are recommended. A search string was formulated to retrieve CPGs and another to identify SR of Randomized Controlled Clinical Trials (RCT). We focused on therapies recommended by those CPG for treating manic or mixed episodes or for prevention of manic episodes in BD-I. We searched MEDLINE, EMBASE, CRD Database and National Guidelines Clearinghouse. RESULTS: We retrieved ten CPG from several countries and three SR of interest. Guidelines issued recommendations on indications for psychiatric admission, pharmacological interventions for the management of acute mania, acute depression, maintenance and long-term care and psychosocial and non-pharmacological interventions. The SR for treatment of acute mania included sixty-eight trials with 16,073 patients assigned to 14 different treatments. Most trials (79%) comprised two study groups, the mean duration was 3.4 weeks, and the mean sample size was 105.7 patients per group. The second SR was an update of the first, with 57 studies involving 95 comparisons with 14,256 patients. Treatments were found to be superior to placebo with small differences in efficacy. The last SR (33 trials with 6,846 patients) analyzed drugs for long-term/maintenance treatment. Most drugs were better than placebo for any mood episode relapse or recurrence. CONCLUSIONS: Good quality evidences about treatment options are available for almost every aspect of bipolar disorder. Detailed publications can help clinicians find the therapy that best suits each patient during mania, depression and for maintenance treatment.