Breath-holding spells are involuntary reflexive episodes in infants triggered by a provocation, which can result in seizures and loss of consciousness. The exact pathophysiology is yet unknown, but a dysregulation of the autonomic system seems to play a role. Several studies have examined the influence of iron, personality traits and oxidative stress, and treatment with iron has been shown to be effectful in some cases. Concentration problems and an increased risk of developing syncope later in life have been described. The level of evidence is low, and more future studies are needed, as argued in this review.