Researchers and mental health professionals have paid growing attention to identify risk factors contributing to the prediction, assessment, and treatment of behaviorally at-risk youth. Among the well-established psychological factors associated with the development and persistence of antisocial behavior during adolescence, the role of psychopathy as well as moral cognitive processes has been emphasized over decades. In this paper, the link between psychopathic traits, self-serving cognitive distortions and antisocial behaviors during adolescence has been examined through a review of the literature focused on empirical studies. Furthermore, starting from the studies on the treatment of psychopathy, which highlighted how the longstanding “Nothing Works” doctrine has been overtaken by the more recent “What Works” approach to offender treatment, we tried to point out some treatment implications for preventing and counteracting antisocial behaviors among psychopathic youth. In this regard, guided by previous research that recognized the self-serving cognitive distortions as cognitive expression of psychopathic traits, we suggested the need to early identify youth’s self-serving cognitive distortions and the potential benefits of focusing on cognitive restructuring processes, especially for those individuals with high levels of psychopathic personality traits. After overcoming the rooted view of psychopathy as untreatable condition, we concluded this paper by providing some relevant suggestions, both for juvenile justice systems and clinical settings, in the field of prevention and treatment, to break the psychopathy-violence link during adolescence and adulthood effectively.