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Saliva plays a key role in the maintenance of oral health. Xerostomia or reduced salivary flow is a common clinical complaint that predisposes individuals to oral diseases and considerable discomfort that may manifest as increased incidence of caries, susceptibility to oral Candidiasis, altered taste sensation, glossodynia and numerous other problems. Xerostomia may occur with the use of medication; as a complication of connective tissue and autoimmune diseases; with radiation to the head and neck region; or with a number of other systemic or local conditions. Investigations for xerostomia include a thorough clinical and oral examination; salivary flow rate estimation; radiologic and histopathologic examination of the salivary glands. Clinical laboratory tests are also indicated to help in the diagnosis. Patient education plays a vital role in the management of Xerostomia. The general approach to treatment consists of palliative treatment for the relief of symptoms and prevention of oral complications. Relief of symptoms may be achieved by paying rigorous attention to personal oral hygiene; diet counseling; drug substitution/dose modification. Salivary flow may be enhanced by using medication or by gustatory stimulation. Artificial saliva substitutes may be used for relieving symptoms. Alternative therapy like acupuncture may be sought if conventional treatment has failed to offer relief. Complications like increased incidence of dental caries, candidiasis, difficulty in using dentures, usually associated with Xerostomia can be managed by giving rigorous attention to personal and professional oral hygiene measures; strict adherence to non cariogenic diet; placement of sealants and topical fluorides; and anti-fungal therapy.