Despite decades of research, both understanding and availability of pharmacological interventions for autistic people are limited. We examined characteristics of pharmacological trials on ClinicalTrials.gov (N = 235) to elucidate trends, identify gaps, and suggest future research directions. We observed that trials predominantly sampled school-aged children and adolescents and focused largely on core autism symptoms, neglecting younger children and adults as well as associated symptom domains often identified by stakeholders as treatment priorities. A variety of intervention agents were trialed, with nearly 60% appearing in just one study. Notably, in line with previous research, there was little consistency in outcome measures used, with the majority (58.9%) used in only one trial. Innovation in research strategies is urgently needed; potential directions for such changes are discussed.