A review of chronic refractory cough ( CRC ) on A4Medicine. This starts with a guide to an aetiology of cough based on the duration – ie acute , subacute and chronic. The management depends on the possible aetiology and the reader is presented with current understanding of this problem. It should be noted that most coughs of duration 3-8 weeks are caused by airway hyperresponsiveness following specific infections.Definition and clinical features of chronic refractory cough are mentioned and the red flags are clearly mentioned. GPs are presented with management options as speech pathology intervention and pharmacological therapy is discussed. Some of these interventions are initiated in secondary care whereas Proton pump inhibitors and corticosteroids are usually trialled in primary care before a referral is made.