Hyponatremia, defined as a serum sodium concentration below 135 mmol/L, is the most common electrolyte disturbance encountered in clinical practice, particularly in the intensive care unit (ICU). It is associated with a spectrum of clinical manifestations, ranging from mild, nonspecific symptoms to severe, life-threatening neurological complications. Even mild hyponatremia (serum sodium 130–134 mmol/L) has been linked to increased mortality, falls, and cognitive impairments, especially in the elderly. Effective management requires a comprehensive understanding of the underlying pathophysiological mechanisms, careful assessment, and prompt, appropriate treatment to prevent complications such as cerebral edema and osmotic demyelination syndrome [1, 2] [Ref: Algorithm 22.1].