Intradialytic hypotension (IDH) is a common occurrence in hemodialysis. IDH occurs when there is a drop in blood pressure along with hypotensive symptoms. There are various causes of IDH, and it is important to consider proper management of this condition. One strategy is to administer vasoconstrictor medication before the hemodialysis session to decrease the risk of IDH. A vasoconstrictor medication used for IDH is midodrine. Midodrine is an oral alpha-1 adrenergic receptor agonist. Evidence on its long-term efficacy and safety data is lacking. This article describes important information on midodrine for nephrology practitioners.