Attention deficit hyperactivity disorder (ADHD) is the most common neuro-behavioral disorder characterized by a classical triad of hyperactivity-impulsivity and inattention prevalent in 5% of school-going children, mostly in boys. It is a chronic disorder with persistent of symptoms in a significant proportion of children diagnosed in childhood and impairing in most domains of socio-occupational functioning. Challenges in diagnosis occur due to symptoms domains of ADHD representing extremes of developmental processes of hyperactivity and inattention. Temperament is another construct that is important while evaluating a child with ADHD to avoid misdiagnosis and/or overdiagnosis. There is literature to support that the presentation of ADHD is not just limited to the triad of symptoms described in DSM 5, but it manifests a plethora of symptoms which, in the majority of cases, often go unnoticed. These symptoms may be a result of executive function deficits, emotion dysregulation, the presence of comorbid disorders, and/or psychosocial issues. Impairments of ADHD continue into adolescence and adulthood. However, ADHD in adults is still an under-researched area. The article aims to provide a bird’s eye view of the various hidden difficulties inherent in ADHD but which often is missed in clinical practice.