Orthostatic hypotension is defined as a sustained decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with blood pressure from the sitting or supine position. It results from an inadequate physiologic response to postural changes in blood pressure. Orthostatic hypotension may be symptomatic or asymptomatic. It occurs in all age groups, but the prevalence increases with age. In the general population the prevalence of orthostatic hypotension is 0.5%, whereas in patients older than 65 years is between 5-30%. It may be the first sign of dysfunction of the autonomic nervous system and is a common symptom in primary and secondary diseases of autonomic nervous system (multiple system atrophy, Parkinson's disease, diabetic autonomic neuropathy), but more often is a side effect of medications such as diuretics and antidepressants, as well as a consequence of hypovolemia. Common symptoms include dizziness, lightheadedness, blurred vision, weakness, fatigue, nausea, palpitations, and headache. Evaluation of suspected orthostatic hypotension begins by identifying reversible causes and underlying associated medical conditions. Although it is difficult to treat orthostatic hypotension, the goal is to reduce symptoms and improve quality of life. Treatment can be pharmacological and non-pharmacological. Non-pharmacological involves lifestyle changes and is recommended for all patients. For patients who do not respond adequately to nonpharmacologic treatment, fludrocortisone, midodrine, and pyridostigmine are pharmacologic therapies proven to be beneficial.