Acute cough is a common presenting symptom in the ambulatory care setting in the United States. It imposes a significant symptom burden on patients and financial burden on the health care system. In most cases, acute cough is caused by a benign viral infection that will resolve without intervention. When needed, there are few evidence-based interventions to hasten the resolution of cough symptoms. Patients may request antibiotics or prescription cough syrups; however, these medications have little evidence of benefit and can be potentially harmful to the patient. It can be challenging for the clinician to provide reassurance while minimizing unnecessary prescriptions. The health care provider also must be alert to signs and symptoms that could signal a high-risk diagnosis that requires urgent evaluation. This monograph provides a review of the differential diagnosis for acute cough, an algorithmic approach to the evaluation of cough, and evidence-based treatment recommendations. Also, it highlights warning signs and symptoms that should trigger an emergent referral and special clinical considerations in more vulnerable patient populations, including pregnant patients and geriatric patients.