More than a century after its initial clinicopathologic description, amyotrophic lateral sclerosis (ALS) remains a largely fatal, progressive neurodegenerative disorder for which few efficacious pharmacotherapies with an impact directly on the natural course of the illness exist. The only currently approved therapy, the antiglutamatergic agent riluzole, has been shown to have only a marginal survival benefit in the absence of changes in functional assessments during the disease course. The efficacy of recombinant human insulin-like growth factor (rhIGF-1) remains controversial. In light of this, the primary focus of treatment for individuals with ALS remains symptomatic, through a multidisciplinary team approach including physicians, nurses, speech/language pathologists, physical therapists, occupational therapists, dietitians, social workers, and respiratory therapists.