The approach to the hypocalcemic patient is best considered with due regard to the underlying etiology and the extent to which features of hypocalcemia are present. When hypocalcemia is a medical emergency, aggressive but judicious measures must be taken immediately to correct, in part, the hypocalcemia. Parenteral therapy of hypocalcemia is advisable only under these conditions. The aim of acute management is not to return the serum calcium to normal but rather to ameliorate the acute manifestations of hypocalcemia. If the hypocalcemic state is owing to a chronic condition that will not remit, a plan for long-term management with a vitamin D preparation and calcium supplementation is implemented after the emergency therapy is provided.