Postprandial hypotension is a common disease of the elderly, defined as a 20 mmHg drop in systolic blood pressure after a meal or a drop in systolic blood pressure from ≥100 mmHg before a meal to <90 mmHg after a meal, or when symptoms such as dizziness or even syncope occur after a meal, even if the drop in blood pressure does not reach the above criteria, postprandial hypotension can also be diagnosed. The incidence of postprandial hypotension has been increasing in recent years, and it is more likely to occur in elderly patients, especially those with hypertension, diabetes mellitus and autonomic dysfunction caused by various reasons, sometimes accompanied by upright hypotension. The prevalence of postprandial hypotension ranges from 24% to 36% in the elderly in home care and 74.7% in our hospitalized elderly patients. Postprandial hypotension is also common in patients with diabetes, with a prevalence of 37% in diabetic patients. The pathogenesis of postprandial hypotension is still unclear, but it may be related to the increase in visceral blood perfusion after meals, which decreases the return blood volume and cardiac output, decreases the sensitivity of pressure receptors and the insufficiency of sympathetic tone compensation after meals, and increases the secretion of vasoactive peptides with vasodilating effect after meals. Compared with young and middle-aged patients, elderly patients have a higher incidence of postprandial hypotension and are more likely to show symptoms of tissue hypoperfusion, which increases the risk of falls, fractures and target organ damage. Prevention of postprandial hypotension is the main focus. For asymptomatic patients, non-pharmacological treatments such as drinking water before meals, reducing sugar intake, avoiding taking antihypertensive drugs before meals, and good blood pressure monitoring can be taken. For symptomatic individuals, drugs that reduce visceral blood flow, inhibit glucose absorption and increase peripheral vascular resistance are the mainstays.