Atomic nuclei exhibit approximate pseudospin symmetry. We review the arguments that this symmetry is a relativistic symmetry. The condition for this symmetry is that the sum of the vector and scalar potentials in the Dirac Hamiltonian is a constant. We give the generators of pseudospin symmetry. We review some of the predictions that follow from the insight that pseudospin symmetry has relativistic origins . We show that approximate pseudospin symmetry in nuclei predicts approximate spin symmetry in anti-nucleon scattering from nuclei. Since QCD sum rules predict that the sum of the scalar and vector potentials is small, we discuss the quark origins of pseudospin symmetry in nuclei and spin symmetry in hadrons.