Syncope is associated with considerable costs to society as well as to the patient. Syncope may arise on a neurological, cardiac, or neurovascular background. Cardiac and neurological causes are evaluated by standard methods. Neurovascular syncope is diagnosed by tilt table testing and carotid massage. The treatment of neurological or cardiac syncope aims at the underlying cause, whereas the treatment of neurovascular syncope consists of information and instruction in reasonable precautions. In persisting cases, medical treatment or pacemaker implantation may be necessary.