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Hyperprolactinemia is the most common endocrine disorder of the hypothalamic-pituitary axis. The causes range from benign conditions which need no treatment to major medical problems requiring multidisciplinary intervention. This special topic issue includes articles on the determination of the etiology of hyperprolactinemia and the epidemiology and management challenges in prolactinomas in general, and in postmenopausal women. Furthermore, dopamine agonist therapy, as first choice treatment, is reviewed from the 1970s to today. The management of agonist-resistant prolactinoma is also described. To complete the overview, giant prolactinomas, aggressive and malignant prolactinomas, lactotroph tumors, and surgery of prolactinomas are covered.