This chapter describes clinical approach to progressive supranuclear palsy. Progressive supranuclear palsy (PSP) was described in 1963-1964 by Steele, Richardson, and Olszewski and is recognized as one of the commoner “atypical parkinsonian” syndromes. The prototypic PSP-Richardson syndrome (RS) can be easily recognized once the disease has developed, and the core diagnostic features are codified in the National Institute for Neurological Disorders and Stroke and Society for PSP (NINDS-SPSP) and the Neuroprotection and Natural History in Parkinson Plus Syndromes clinical diagnostic criteria. The oculomotor examination is a key part of the diagnostic assessment and should include assessment of blink rate, eyelid dysmotility, and vertical and horizontal saccadic eye movements with particular attention paid to latency and velocity. The mainstay of treatment is supportive care and all patients should be reviewed by dietitian, speech therapy, physiotherapy, and occupational therapy.