Physiotherapy for VVS consists of two main methods: one is to perform counterstress maneuvers when the patient has an aura of syncope, i.e., isometric contractions of the muscles of the extremities [such as leg crossing, and increased muscle tone of the upper extremities such as upper arm tensing and hand grip], which can enhance the pumping of skeletal muscles, increase venous concentric blood volume, and This has been used as a treatment for VVS because it improves cardiac output. Studies have shown that simultaneous cross-contraction of the upper and lower extremities for 30 s before tilting upright increased the mean arterial pressure from 65 mm Hg to 106 mm Hg during tilting in patients with VVS and effectively prevented syncope [12]. Another study showed that clenching the hands and holding upper extremity muscle tension for 2 min during the initial phase of HUT-induced symptoms increased systolic blood pressure in the study group and decreased it in the control group, with 37% and 89% of patients in the two groups experiencing syncope, respectively. By using this anti-stress maneuver at the onset of syncope prodromal symptoms, only one of the 95 VVS patients had a syncopal episode during clinical follow-up. The second type of physical therapy for VVS is tilt training (TT). Repeated tilt training improves tolerance to upright posture and has the potential to restore abnormal pressure reflex activity in patients. For therapeutic TT, patients with a positive tilt test are first given tilt training in the hospital, similar to the upright tilt test, and then discharged from the hospital to begin home training when the patient has had two consecutive negative tilt training sessions. The method of home training is to ask the patient to place the upper back against the wall, with both feet 15 cm away from the wall in a tilted position. Under the supervision of family members, the duration of each training session can be gradually increased from 15 min to 30~45 min, and the training is required once or twice a day. Results from several centers have shown that this training method has a very satisfactory effect on the treatment of vasovagal syncope. However, some studies have also found poor compliance with this treatment method, making it difficult to obtain the expected efficacy. Systematic studies on the application of the above physiotherapy methods in pediatric VVS patients have been reported very rarely, and their treatment methods and effectiveness remain to be explored. However, since the above methods have no or minimal risk, and the current findings support their effectiveness and lack of cost, they should be recommended as a basic treatment for pediatric patients.