Behavioural and psychological symptoms of dementia (BPSD) are common in dementia. They cause significant distress to people with dementia and their carers. In managing BPSD, medical causes such as delirium must be excluded. Non pharmacological management, such as environmental and behavioural interventions are effective first line strategies. Medication may be useful in moderate to severe BPSD but must be used carefully in view of the risk of side-effects.