Hysteria, as classically defined (before Freud), is a chronic polysymptomatic illness chiefly affecting women. A dramatic and complicated medical history is the rule. Although the etiology of this condition remains unclear, its implications for physicians are different from those of other illnesses. Clinical management is generally difficult and often unsatisfactory. As with other diseases, diagnosis precedes and directs treatment. This article discusses the basis on which a reliable diagnosis of hysteria can be made, and offers guidelines for conservative management, based on the clinical literature and the author's experience.