Agitation is a common and urgent condition involving motor hyperactivity and symptoms such as irritability, combativeness, or impaired judgement. Rapid assessment and effective treatment are necessary to manage agitation and, potentially, to shorten the time to recovery. Rapid treatment with intramuscular (IM) typical antipsychotics and/or benzodiazepines may be essential to prevent injury to the patients or others. However, IM typical antipsychotics are associated with acute extrapyramidal side effects, and IM benzodiazepines may cause excessive sedation leading to respiratory depression, ataxia, and confusion. Recently, an IM formulation of olanzapine may present several treatment advantages when rapid treatment of acute agitation is essential in patients with schizophrenia, bipolar disorder, and others. In addition, rapid initial dosing with olanzapine may be a useful approach to manage acute agitation in some patients with schizophrenia.