An underlying component of stress that manifests in physical symptoms is present in a high percentage of patients visiting the family practitioner, who is expected to help them cope with stress. In this article the transactional model of stress is briefly explained. Guidelines are given for assessing the role of stress in physical symptoms and for consulting with stressed patients. Subsequently, some stress moderators are discussed and guidelines are given for implementing these in practice. Lastly, primary, secondary and tertiary stress interventions in primary health care are briefly discussed.