For a study, it was determined that syncope was a significant clinical issue for which no cause has been found. The impact of age at first syncope on the final syncope diagnosis has not been extensively researched. Patients with unexplained syncope who underwent consecutive head-up tilt testing (n=1,928) were categorized according to their age at the time of their first syncope. Clinical characteristics, including the patient’s age at first syncope and when the research was conducted, were compared with the final syncope diagnosis. There was a bimodal distribution of syncope ages, with 15 and 70 years peaks. Prodromes (64% vs. 26%, P<0.001) and vasovagal syncope (59% vs. 19%, P<0.001) were more prevalent in early-onset (>60 years) compared with late-onset (<30 years). Increased incidence of late-onset syncope was determined in those with orthostatic hypotension (3 vs 23%, P<0.001), carotid sinus syndrome (0.6 vs 9%, P<0.001), and complex syncope (>1 concurrent diagnosis). In persons aged 60 years and up, 12% had early-onset syncope and 70% had late-onset syncope; age at first syncope was associated with increased odds of OH (+31%, P<0.001) and CSS (+26%, P=0.004). The presence of prodromes (on average, 26 years old) and the diagnoses of VVS (on average, 35 years old) and complex syncope were linked to an earlier age at first syncope (both +23%, P<0.001). In individuals with no apparent cause for their syncope, the first-time syncope rate had a bimodal lifetime distribution that peaks at ages 15 and 70. Only recent syncope was typical in older individuals, and OH and CSS were more common. Prodromes, VVS, and complex syncope were more frequent in individuals with early-onset syncope.