Introduction: Hyponatremia, the most frequent electrolyte derangement identified among hospitalized patients, is associated with worsened outcomes in patients with pneumonia, heart failure and other disorders. In this study we will try to assess different etiological, clinical and epidemiological parameters relater to hyponatremia. Materials and methods: Elderly patients (60 yrs and older) admitted in medical ICU between 1st of April,2017 and 31st of October 2018 with hyponatremia were assessed in this study and the diagnostic criteria was– Hyponatremia: Serum Sodium level < 135 mMol/L Severe Hyponatremia: Serum Sodium < 125 mMol/l Results: The most common cause of hyponatremia was siadh, followed by renal loss, drug induced, gi loss and others. At the time of admission 60% were euvolemic,27% were hypervolemic and 13% were dehydrated. Among the patients studied 13 patient had serum sodium levels of less than 105 mmol/l, 26 patients had serum sodium level of 105–115 mmol/l and 61 patients had serum sodium levels of 115–125 mmol/l. Among the groups of hyponatremia based on their volume status and on comparison of their relation to outcome, it was seen that there was no significant difference between the groups with regard to outcome and type of hyponatremia. Conclusion: In this study the commonest cause of hyponatremia was due to SIADH ( 30%) followed by renal causes (23%), then drugs (21%) of which diuretics form a major chunk, Of these etiologies the worrisome cause is Drug induced hyponatremia, as a major chunk of drugs that cause hyponatremia are diuretics. Though JNC VII recommends diuretics as the first line drug for treatment of hypertension, a word of caution should be maintained while prescribing diuretics in the elderly and when required doses should be modified according to body weight and should begin with the lowest dose