The mainstay of treatment of amyotrophic lateral sclerosis (ALS) is management of symptoms. Health care providers involved in the care of ALS patients should be armed with the most current knowledge about symptomatic management of these patients so that an aggressive approach to controlling symptoms can be undertaken at the most appropriate time. Among the important modalities is noninvasive positive pressure ventilation, which has been shown to improve not only quality of life but also survival. Similarly, clinicians should consider earlier intervention with enteral feeding. Palliative care should begin soon after ALS is diagnosed.