Progressive supranuclear palsy (PSP) is a rare late-onset neurodegenerative disease characterized by ocular motor dysfunction, postural instability, akinesia-rigidity, and cognitive dysfunction. It involves the gradual deterioration and death of specific volumes of the brain, linked to 4-repeat tau pathology. Symptoms include loss of balance, blurring of vision, problems controlling eye movement, changes in mood, behavior, and judgment, cognitive decline, and slowing and slurred speech. PSP may be misdiagnosed as Parkinson's disease due to similar symptoms. Most cases appear sporadic, but some are familial. Genetic changes in the MAPT gene have been linked to PSP, and other genetic factors are under study. PSP affects movement, balance, thinking, and eye movement, with symptoms typically appearing in mid- to late adulthood. Loss of balance, falls, walking difficulties, slow movements, stiffness, and abnormal eye movements are common. Additional features include slow and slurred speech, swallowing problems, personality changes, cognitive difficulties, and a need for wheelchair assistance as the disease progresses. Eye movement issues, including vertical gaze palsy, are a hallmark of PSP. Medications like levodopa and amantadine may be beneficial in some cases.