Abstract Generalized anxiety disorder (GAD) is common in clinical practice. Most cases are comorbid with another Axis I disorder, notably mood disorders like major depressive disorder and bipolar disorders, and with many chronic medical illnesses. Although trivialized as a disorder, GAD is consistently associated with considerable disability and with overutilization of medical services. The diagnostic criteria for GAD have shifted more than most other Axis I disorders over the past two decades and even differ significantly between DSM-IV and ICD-10. In the past two decades, there have been a substantial number of failed double-blind studies on GAD, even with treatments expected and suspected to work effectively. The neurobiology and genetic underpinnings of the disorder are little understood and its pathophysiology is unclear, especially in differentiating it from its neighboring disorders. These and changes in the healthcare marketplace have led to ever-diminishing interest in investing in scientific research and development of new treatment for this disabling condition. However, there are several effective treatments for GAD. Although time to remission is slow and long-term treatment is usually necessary, many achieve good outcomes when properly managed.