Piriformis syndrome is characterized by hip and buttock pain, and is belong to categories of low back pain which is a common complaint in out-patient department. Because of its similar presentation to lumbar radiculopathy or sacral joint dysfunction, this syndrome is often been overlooked. However, for more accurate diagnosis requires understanding structure and function of piriformis and its relationship to sciatic nerve. This article provides state-of-the-art knowledge about the syndrome, including medical management.