Although extrapyramidal diseases are commonly thought to solely affect the (extrapyramidal) motor system, non-motor symptoms such as behavioural abnormalities, dysautonomia, sleep disturbances and sensory dysfunctions are also frequently observed. Autonomic dysfunction as an important clinical component of extrapyramidal diseases (idiopathic Parkinson's disease, multiple system atrophy, progressive supranuclear palsy, dementia with Lewy bodies) is often not formally assessed and thus frequently underdiagnosed. Symptoms of autonomic dysfunction can have more impact on quality of life than mild motor symptoms. Appropriate symptom-oriented diagnosis and symptomatic treatment as part of an interdisciplinary approach can provide a great benefit for the patient. Unfortunately, double-blind, randomised, controlled studies are scarce with the consequence that most recommendations are not based on the highest level of evidence. This review presents a limited overview on the treatment of cardiovascular, gastrointestinal, and sudomotor autonomic dysfunctions in various extrapyramidal syndromes.