The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is the most common cause of euvolaemic hyponatraemia. However, although first described over 50 years ago, the management of hyponatraemia secondary to SIADH is not always straightforward. Some of the issues surrounding the management of hyponatraemia secondary to SIADH were explored in the European Hyponatraemia Survey completed by attendees of the European Hyponatraemia Network Academy Meeting 2011. This article describes the findings of this survey and the specific issues raised regarding the management of hyponatraemia secondary to SIADH in Europe. Some of these issues – including awareness, education, diagnosis, management and cost considerations of the condition – were common to countries across Europe.