Syncope is a relatively common clinical syndrome that is a subset of a broader range of conditions that cause transient loss of consciousness (TLOC). Other TLOC conditions include seizures, concussions, and intoxications. However, despite frequent confusion in the medical literature, syncope is and should be clearly distinguished from those other causes of TLOC by virtue of its pathophysiology; specifically, syncope is the result of self-terminating inadequacy of global cerebral nutrient perfusion, while the other forms of TLOC have different etiologies. Unfortunately, the diagnostic evaluation of syncope remains for the most part poorly managed and inefficient. Careful history-taking, physical examination, and judicious use of tests can not only increase the diagnostic yield of the evaluation, but also increase patient safety and reduced overall healthcare costs.