Mladic, 70, is accused of genocide over the siege of the Bosnian capital Sarajevo and the 1995 killing of 8,000 Muslim men and boys in Srebrenica, Europe's worst massacre since World War Two.
Already in poor health when arrested in Serbia last year after 16 years on the run, Mladic has several times said he is too ill to stand trial. He complains that he suffers from the effects of a stroke, has problems with his teeth, and has been admitted to hospital with pneumonia.
Prosecutors and relatives of victims fear that he could die without facing justice, as happened with former Yugoslav strongman Slobodan Milosevic, who died in a Dutch prison cell in 2006 while on trial before the International Criminal Tribunal for the former Yugoslavia in the Netherlands.
Tribunal spokeswoman Nerma Jelacic told Reuters: "He (Mladic) complained he was feeling unwell during the hearing, so the hearing was adjourned."
The court said the hearing would resume on Friday if Mladic could attend. Otherwise, an update would be given, Jelacic said.
"He really looked unwell," Mladic's lawyer Branko Lukic told Reuters. "It was a huge surprise for all of us because he'd been looking in pretty good shape."
A Reuters witness said Mladic asked for a break shortly after Thursday's session opened. He then put his head in his hands, and the judge called for medical staff and adjourned the hearing.
A member of Mladic's defence team had accompanied him to hospital, Lukic said.
Earlier this year, the opening of the trial had to be postponed after it emerged that the prosecution had failed to disclose thousands of pages of evidence to the defence.
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