Physical therapy involves caring for patients at risk for experiencing abnormal hypotension that develops during upright activities or exercise. A patient experiencing an abnormal drop in blood pressure during physical therapy may be at increased risk for injury resulting from a fall or a syncopal event. Alternatively, the context of the drop in blood pressure may indicate that the patient may have an undiagnosed pathology that may need further medical workup. Therefore, an understanding of orthostatic hypotension and exertional hypotension is critical to the physical therapy clinician. An overview of these distinct forms of hypotension is provided, and implications for the practicing clinician are described. A case study of each condition has been incorporated to help the reader integrate the concepts presented into clinical practice.