The genus Flavivirus in the family Flaviviridae consists of many arthropod-transmitted human pathogens, including dengue, yellow fever, Japanese encephalitis, West Nile, St. Louis encephalitis, Murray Valley encephalitis, and tick-borne encephalitis viruses. Treatment options against flaviviral disease are extremely limited, with no effective drugs yet commercially available. Recent advances in virology, synthetic organic chemistry, and the discovery of RNA interference (RNAi), have provided the basis for advances in the development of antisense-based approaches to address flaviviral infections. Oligomers of various antisense structural types, targeted to different locations in the flaviviral RNA genome, have now been used to successfully suppress viral gene expression and thereby inhibit flavivirus replication. Double-stranded RNA, containing viral sequence and designed to induce the endogenous cellular machinery of RNAi, has also been shown capable of potently interfering with flavivirus production and transmission. These studies provide insights into flaviviral molecular biology and the basis for the development of novel therapeutic approaches. The goal of this review is to summarize the findings of many of the significant reports that have appeared on the topic of antisense-mediated strategies for the development of antiviral therapy for flaviviruses.