Syndrome of inappropriate ADH (SIADH) secretion is a condition where there is an increase in the secretion of ADH resulting in retention of excess water in the body. ADH or Antidiuretic hormone (also called Vasopressin) is produced in the hypothalamus of the brain and released by the pituitary gland. The main biochemical abnormality is low plasma sodium or hyponatraemia. However hyponatraemia can occur for multiple reasons and it is important to diagnose the specific cause as the management can vary. SIADH is a cause for euvolaemic hyponatraemia and the management includes stopping the drug responsible for causing it, fluid restriction and using medications like Tolvaptan and Demeclocycline. The audit below is an attempt to find out if the prevailing Guidelines were considered during the management of SIADH in our hospital.