Phosphate disorders are very common especially in hospitalised patients.As phosphate is not routinely measured with serum electrolytes, it often remains undetected. Phosphate disorders have serious clinical consequences which can be easily avoided or treated if the phosphate abnormalities are detected. This is especially true for patients who are critically ill, ICU patients on ventilators, patients with muscles and bone diseases, patients with renal or intestinal diseases, or endocrine abnormalities, etc. Disease burden, disease-related disability and cost is a significant problem especially when not managed appropriately. The cost and burden on health care is very high, but the treatment of these disorders is simple. Physicians managing these cases need to be mindful of these preventable and treatable disabilities. Junior doctors and trainees often find it hard to understand these issues and manage electrolytes especially phosphate. This review article focuses on the elaboration of these biochemical changes of phosphate, its clinical implications and management.