Orthostatic hypotension (OH), defined as a decline in blood pressure when a person moves from a supine to sitting or standing position, is a common physical finding in the primary care setting. It is associated with several medical conditions and its prevalence increases with age. Treatment is specific to cause. Drug-induced OH often can be alleviated by reducing dosage or completely changing medications. OH secondary to autonomic insufficiency or neurogenic causes remains a challenge to manage, and a combination of non-pharmacologic and pharmacologic measures are needed. Recommendations are made for preventive measures, patient and caregiver education, and nonpharmacologic and pharmacologic approaches to treatment. Approaches to managing OH in conjunction with hypertension are also discussed.