Syncope is defined as a sudden and temporary loss of consciousness due to global cerebral hypoperfusion. It is characterized by having a relatively rapid onset and brief duration with spontaneous and full recovery. Syncope may have multiple possible causes, ranging from benign conditions to life-threatening diseases. Syncope can be classified into four categories: reflex mediated, cardiac, orthostatic, and cerebrovascular. In approximately 30 percent of cases the patient is considered to have an unexplained diagnosis. The major challenge in the evaluation of patients with syncope is that most patients are asymptomatic at the time of their presentation. The initial evaluation of suspected syncope relies heavily on obtaining of a comprehensive history, performing a physical examination, and reviewing an electrocardiogram. These steps should guide the subsequent diagnostic evaluation and help limit unnecessary testing and treatment. In patients with suspected cardiac syncope, monitoring is indicated until a diagnosis is made. In patients with suspected reflex syncope or orthostatic hypotension, outpatient evaluation is appropriate. The risk of death is primarily determined by the severity of underlying cardiovascular disease. The management of the patient with syncope is based upon the underlying cause of syncope. The principal goals of treatment are to prolong survival, limit physical injuries, and prevent recurrences.