The paper presents current views on the pathophysiology and treatment options in the restless legs syndrome (RLS) and periodic limb movements in sleep (PLMS). Moreover, concepts are outlined concerning possible involvement of various cerebral structures as well as neurotransmitter and metabolic systems in the RLS pathophysiology, with the focus on the role of dopamine and iron deficiency. Dopaminergic agents (i.e. L-dopa and dopamine agonists), currently regarded as the best therapeutic option in the treatment of RLS, are discussed in detail. Favorable outcomes attained in the treatment of RLS with the opioid receptor agonists, anticonvulsants, benzodiazepines, and adrenolytic agents are also reported.