Cough is a common manifestation of many respiratory conditions and mostly is non-specific on its own as a symptom of the underlying disease. Most transient coughing episodes tend to settle within 2-3 weeks. Yet cough can herald more sinister disease such as malignancy or progressive respiratory conditions. In epidemiological surveys, cough persisting more than 8 weeks has been shown to have a significant impact on the quality of life and is often difficult to diagnose and treat, taking weeks to months. There is consensus that a logical, evidence-based, standardised approach is most likely to lead to an efficient diagnosis and provide the highest chance of effective resolution. This paper describes the current evidence and offers a best practice approach for primary care practitioners and general internists.