This chapter discusses the pathophysiology and management options of different types of ‘syringomyelia.’ Pathogenesis of syrin-gohydromyelia is not understood completely. CSF flow dynamics play an integral role. Long history of slowly and progressively dissociated sensory loss is the usual presentation. Early intervention to halt or reverse symptoms and prevent irreversible spinal cord damage may be considered; prognosis is good in the young. Palliative treatment only in cavitation type and in syrinx associated with arachnoiditis. Tumor associated syrinx do not require specific treatment. Treatment of asymptomatic syrinx is controversial.