Although vasovagal syncope is the most frequent cause of loss of consciousness, the ability of diagnostic and therapy is still weak. The most important diagnostic method in vasovagal syndrome is the tilt test. The number of clinical trials of the effective treatment of vasovagal syncope is still small. This article attempts to summarize the most important clinical problems connected with vasovagal syncope and includes present guidelines of European Society of Cardiology. The treatment of vasovagal syndrome is mainly based on tilt training and non-pharmacological methods. Presently, there is a lack of evidence for the efficiency of pharmacological treatment. Cardiac pacing should be limited as a choice to a very small group of patients affected by severe cardioinhibitory type of vasovagal syndrome.