Hyperprolactinemia and prolactinomas are the most common neuroendocrine disorder in clinical practice. Clinical symptoms result from effects of hyperprolactinemia and from mass effects of the tumour expansion. Identifying of the correct cause of hyperprolactinemia is important to establish the correct treatment. There are many causes, such as hypothyroidism, medication use, renal or hepatic failure, prolactinomas and other tumours in the hypothalamus-hypopituitary region, as well as macroprolactinemia might be also considered. Hyperprolactinemia has been described in many autoimmune diseases. If these causes were ruled out and pituitary imaging was negative, idiopathic hyperprolactinemia is diagnosed. In symptomatic patients treatment with dopamine agonists is indicated, cabergoline is preferred because of its high efficacy and good tolerability profile.