Introduction: This is a syndrome in which the sciatic nerve (SN) in its course under the piriformis muscle (PM)/level of the ischial tuberosity presents a compressive process. Objective: To describe the epidemiology of piriformis syndrome (PS), its pathophysiology, differential diagnoses, etiology, symptoms and clinical signs, complementary exams, conservative and surgical treatment. Discussion: Among the symptoms are gluteal pain, lumbosciatica, paresthesia in the inguinal, lumbar, perineal, buttocks, hip and posterior part of the thigh, calf, feet, and rectum. The radiography of the pelvis, computed tomography (CT), magnetic resonance imaging (MRI) of the lumbosacral spine, MRI of the pelvis, ultrasound (US), and electroneuromyography (ENM) are relevant complementary exams for better investigation of patients with suspected PS. The treatment should initially consist of a conservative approach, through non-invasive therapies. In addition to oral medications and physiotherapy, therapy performed through injection in the PM has been described. The surgical treatment is indicated as a treatment modality for patients with PS after the failure of conservative treatment has been confirmed. Conclusion: Piriformis syndrome is a controversial disease that requires further study for a better definition of its correct diagnosis and the role of surgery in symptom control.