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Conduct disorder (CD) is a common and costly mental disorder of childhood and adolescence, yet in Malaysia it has rarely been studied as a diagnosis. This critical narrative review compares international evidence on the clinical features, epidemiology, aetiology, assessment, and treatment of CD with the Malaysian literature, drawing mainly on Scopus- and Web of Science-indexed studies published between 2020 and 2026. Its central argument is that the two bodies of evidence do not match: international research increasingly addresses CD as a diagnosis, whereas Malaysian research has mostly examined behavioural indicators and contextual risks. To make this explicit, Malaysian studies were classified into three categories: studies measuring conduct problems directly, studies of associated behavioural indicators such as bullying and fighting, and studies of contextual risk exposures such as harsh discipline and socioeconomic disadvantage. Within the databases searched, no Malaysian study estimating the prevalence of CD with a diagnostic interview was identified. Screening data showed abnormal-range conduct problems in about 5% of preschool children in one state. National surveys showed that about one in six secondary-school students had been in a physical fight in the past year, and that 58.3% of children aged 12–59 months had experienced psychological aggression and 40.7% physical punishment in the previous month. These contextual risks are consistent with international evidence on the development of CD, but their association with CD itself has not been tested in Malaysian samples, and almost all local studies are cross-sectional. A Malay version of the Inventory of Callous-Unemotional Traits has been validated, although its criterion validity remains untested. Behavioural parent training is the best-supported treatment internationally, whereas Malaysian parenting programmes have so far provided feasibility and preliminary data in universal or non-clinical samples rather than effectiveness data for children with CD. We outline priorities for diagnostic epidemiology, culturally informed measurement, prospective research, and indicated intervention trials in Malaysia.
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