Sialorrhea, also known as hypersalivation or ptyalism, is excessive salivation associated with neurological disorders or localized anatomical abnormalities in the oral cavity. Pathologic sialorrhea may develop due to hypersalivation, together with various neurologic disorders including cerebral palsy, Parkinson's disease, and amyotrophic lateral sclerosis, or as an adverse effect of medications. Sialorrhea results in numerous problematic physical and psychosocial complications and has a significant negative impact on quality of life for both the patient and caregiver. The management of sialorrhea is best accomplished with a multidisciplinary team approach. Treatment options range from conservative measures such as observation, positioning, behavioral therapies, and pharmacological therapy to more aggressive methods such as botulinum toxin injections or surgery. The physiology, etiology, assessment, and treatment of sialorrhea are outlined in this review.