The present chapter aims to highlight the latest evidence on risk markers and prodromal symptoms of bipolar disorder. Understanding these aspects is important for identifying patients at a higher risk of developing bipolar disorder, guiding diagnosis, and facilitating early intervention to potentially delay its progression or even prevent full-blown illness. Family history plays a significant role in the onset of the disease, both directly through genetics and indirectly through the family environment. Prenatal and perinatal factors, such as obstetric and pregnancy problems, have been associated with bipolar disorder, and early trauma has a high prevalence rate in individuals with the disorder. Additionally, substance use is both a predictive factor and a stressor that can worsen the course of the illness. Several symptoms precede illness onset, and their recognition can have an important impact on early intervention. The treatment approach includes psychoeducation, cognitive and family-focused therapy, and pharmacological alternatives, which remain a topic of ongoing research.