BACKGROUND AND OBJECTIVES: In patients with neurocardiogenic syncope or presyncope, symptoms developed unpredictably and intermittently. The purpose of this study was to determine whether there was any significant difference in the recurrence rate of symptoms during the follow-up period between patients with many episodes of symptoms and those with fewer episodes of symptoms before diagnosis, as well as to assess the clinical significance of previous episodes of symptoms during treatment. SUBJECTS AND METHODS: A total of 100 patients with neurocardiogenic syncope or presyncope were divided in two groups (high episode group, n=54; low episode group, n=46) according to the frequency of symptoms before the head-up tilt test. We retrospectively analyzed the recurrence of symptoms using telephone interviews and medical record reviews. RESULTS: The clinical characteristics were not significantly different between the two groups. However, the recurrence rate was significantly lower in the high episode group than in the low episode group (5.6% vs. 19.6%, p=0.001). In the high episode group, patients treated with medication showed higher recurrence of symptoms than those without medication. In the lower episode group, a similar result was observed. CONCLUSION: The frequency of previous symptoms at the diagnosis of neurocardiogenic syncope or presyncope did not predict the occurrence of symptoms during the follow-up period. Therefore, to continue drug treatment based on the frequency of symptoms in patients with neurocardiogenic syncope or presyncope may not be the best option.