Raynaud’s phenomenon as a clinical entity was first described in the 19th century. However, there are still many unanswered questions and speculations considering the pathogenesis of this disease. The most important task for a physician on the first encounter with the patient is to recognize the signs indicating the possible secondary nature of the phenomenon. The prognosis of secondary Raynaud’s phenomenon depends on the clinical course of the underlying disease and has lower response to treatment because of the structural changes in vessel walls. Gaining more information about the pathogenetic mechanisms will hopefully allow development of more effective treatment strategies.