On 6 August 2011, London’s usually calm atmosphere was disturbed by gangs of youths attacking shops. By the next day, this had spread to cities and towns across the country and was immortalised in the Daily Mirror headline ‘Tottenham riot leaves London burning’. How do we deal with such aggression, and how do we explain it? First, we need to understand what aggression is, what its role is, and the different forms it takes. This article looks at the causes, types and management of aggression in the acute environment.