Congestive heart failure is a common cardiovascular disorder among adults and is a major cause of morbidity and mortality worldwide. Diastolic heart failure (DHF) is implicated in 1/3 to 1/2 of all heart failure cases and results from an abnormality of ventricular relaxation, compliance or filling. DHF differs from heart failure with reduced ejection fraction in epidemiology, pathophysiology, and natural history. Recent advances have improved our understanding of DHF. This review summarizes these advances and discusses their clinical implications as they pertain to the diagnosis and management of patients with DHF.