INTRODUCTION This chapter on syncope is constructed differently from a standard textbook chapter. Instead of providing a detailed review on various conditions causing syncope, on the complex mechanisms of vasovagal syncope, or on how tilt table testing or an electrophysiologic study is performed, this chapter provides a synopsis of the approach to syncope evaluation according to the patient’s presentation and patient management. It is expected that the reader has reviewed the indications for tilt table or electrophysiologic study after a syncopal event (Chapter 21, “Indications for Electrophysiologic Testing”). The reader should understand the role of syncope as a risk factor in determining prognosis and therapy in patients with various structural and familial conditions. It is also expected that the reader knows the available evidence for the efficacy of various treatment of vasovagal syncope, including the role of β-blocker therapy or pacemaker therapy. Pertinent information from guidelines pertaining to syncope is synthesized in this chapter.