Gastroparesis is a condition of impaired gastric motility that can be chronic and result in decreased quality of life and complete disability. Once the diagnosis of gastroparesis is established, the clinician's attention should immediately focus on restoring nutritional status, providing symptomatic relief from nausea and vomiting, and improving gastric motility. Combination therapy is the rule rather than the exception, and most patients require multiple prokinetic and antiemetic modalities for adequate symptom relief. Currently available medications are often inadequate to achieve therapeutic goals, and newer modalities, such as gastric electrical stimulation, which has been shown to decrease symptoms and improve quality of life, should be employed at a low threshold. Several novel therapeutic options are under investigation and may also become part of the routine treatment of gastroparesis.