Generalized anxiety disorder (GAD) is a prevalent mental condition with substantial impact on psychosocial functioning and quality of life. There is also an increased risk of comorbidity with several other mental and somatic diseases. Clinical symptomatology is characterized by excessive and uncontrollable worrying about distinct issues of daily living which is frequently associated with somatic symptoms of stress and anxiety. Neurobiological and psychological research provide evidence for alterations in (para) limbic areas, a disturbed monoaminergic transmission as well as for dysfunctional learning in the pathogenesis of GAD. Therefore, second generation antidepressants, such as selective serotonin reuptake inhibitors (SSRI), selective serotonin-norepinephrine reuptake inhibitors (SSNRI), the calcium channel modulator pregabalin and cognitive behavioral therapy (CBT) are the first choice treatment options. Depending on symptom severity, patient preference and availability, both medication and CBT can be applied as monotherapy or in combination.