Magnesium deficiency tetany (MDT) is a separate hereditary illness. It occurs more often than is assumed or even diagnosed today. As a consequence the estimated number of undetected cases is high. Neuromuscular symptoms are typical of magnesium deficiency due to neuromuscular hyperexcitability. In a pronounced case, it is referred to as tetany. The aim must be to work toward early detection of the symptoms for magnesium deficiency, giving particular consideration to the underlying genetic regulatory mechanisms of Mg homoeostasis. Most patients suffering from MDT have Mg concentrations in their serum lying in the lower third of the normal range, which, however, should not lead to a misdiagnosis and MDT being erroneously dismissed. An early start of a consistent, causal and lifelong supplementation therapy with sufficiently high Mg doses (600 -1,800 mg, in rare cases up to 20,000 mg Mg per day) and a Mg target value in serum of > 0.9 mmol/1 (in specific cases even higher) can safeguard patient health to a large extent, reduce the risk of secondary diseases, and stave off the need for early retirement. These facts become particularly evident in the numerous case reports of patients.