This brief clinical review summarizes the literature on sleep paralysis most relevant to clinicians. Sleep paralysis is a condition where the sufferer awakens to rapid eye movement sleep based atonia, combined with conscious awareness. This is a frightening event accompanied by vivid, waking dreams and hallucinations. Sleep paralysis occurring independent of narcolepsy and other medical conditions is termed isolated sleep paralysis. Though rare in clinical practice, the unusual nature of the condition and a lack of training during medical residency and graduate education leads to fewer cases being detected. This paper looks at the prevalence, risk factors, diagnosis and management of sleep paralysis. The management consists of both pharmacological and psychotherapeutic interventions that need clear guidelines, empirical support and larger randomized controlled trials.