Essential tremor (ET) is one of the most common movement disorders. However, the etiology and pathogenesis are as yet unknown. Continued research will give us clues to understanding the impact on society, identifying genetic and environmental contributors to the disease, understanding the significance of a sporadic case, the phenotypic spectrum and timing of presentation, and the relationship with other neurologic disorders. Because the condition is both clinically and genetically heterogeneous and there is overlap with these other disorders, such as dystonia, parkinsonism, peripheral neuropathy. and migraine, the definition of phenotype plagues research in this area. Advances in understanding the genetic and molecular underpinnings of tremor should provide additional tools to unravel the clinical phenotype (including physiology), genotype-phenotype relationships, and the epidemiology of tremor.