Physicians who work in primary care settings and neurology departments frequently evaluate patients with low back pain. However, there are wide variations in care, a fact that suggests there is professional uncertainty about optimal approach. In addition, there is evidence of excessive imaging and surgery for low back pain in Korea. In considering diagnostic tests, physicians should apply the principles outlined in an algorithm for the evaluation of low back pain, and must look for red flags- key historical and clinical clue that increase the likelihood of a serious underlying disorder. We discuss the epidemiology and etiology of back pain and review the literatures about diagnostic methods. Korean Journal of Headache 2(2):111-122, 2001