Essential tremor (ET) is the most prevalent movement disorder globally, affecting about 1% of the general population and 5% of those aged over 65 years. Characterized by involuntary, rhythmic oscillations, it primarily manifests as postural and kinetic tremors, predominantly in the upper limbs. Genetic studies, neuropathological examinations, neurophysiological assessments, and various neuroimaging techniques have demonstrated functional, neurotransmitter-related, and structural abnormalities within the cerebello-thalamo-cortical circuit. These findings collectively portray ET as a neurodegenerative syndrome with diverse etiologies and clinical manifestations, highlighting the involvement of the cerebellum.