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OTRS can send out emails via Sendmail (e.g. Sendmail, Postfix, Qmail or Exim). The default configuration is to use Sendmail and should work out of the box.
You can configure the sendmail settings via the graphical configuration frontend (Framework::Core::Sendmail)
OTRS can send emails via SMTP ( Simple Mail Transfer Protocol / RFC 821) or Secure SMTP. You will want to use this on non-UNIX platforms (e.g. Windows).
The SMTP server settings can be configured via the SysConfig (Framework::Core::Sendmail). If you don't see SMTPS available as an option, you miss the required Perl modules. In that case, please refer to "Installation of Perl modules required for OTRS" for instructions.