Postnasal drip (PND) is a common clinical complaint, yet its physiologic basis and appropriate treatment have been inadequately addressed in the medical literature. PND may be caused by a variety of conditions involving the nose and throat. Often, the symptom is not caused by actual secretions draining from the nose into the pharynx. In many instances, no definitive cause can be identified. Empiric treatment for PND symptoms should be guided by associated symptoms that suggest either a sinonasal cause or gastroesophageal reflux. Rarely, PND may be a symptom of a serious process such as a mass lesion in the pharynx or a malignancy and thus referral to an otolaryngologist is appropriate if symptoms are persistent, unexplainable, or associated with warning signs of malignancy.