Intradialytic hypotension is a frequent complication of hemodialysis. Its etiology is complex and multifactorial. Routine management includes modification of dialysis prescription with an approprite assessment of patient’s dry weight, infusions of fluids and plasma expanders and in selected cases pharmacotherapy. Despite the common occurence of intradialytic hypotension no uniform and widely accepted management guidelines has been developed for this complication. It refers specifically to the prevention of recurrent hypotension episodes. Due to multifactorial etiology of this complication its treatment is challenging and should be individualized.