Hyponatremia is a common condition in clinical practice and a major cause of morbidity and mortality. Differentiating between its acute and chronic forms is challenging because of their variable symptoms. A thorough approach is necessary to diagnose hyponatremia. Proper interpretation of the numerous laboratory tests aids in the differentiation of hyponatremia types. In the ICU, management varies for acute and chronic cases to prevent neurological issues. While fluid restriction and hypertonic saline administration are two common forms of management, however, individualized strategies are essential for illnesses like cirrhosis or Syndrome of Inappropriate Anti Diuretic Hormone. To successfully treat hyponatremia, use vaptans and other protocols while monitoring the patient's condition closely. Monitoring acute and chronic cases must adhere to specific monitoring frequency and indices, and should cease only when Na+ levels are deemed safe. Balancing the diagnosis and therapy provides patient safety and avoids side effects.