The concept of heart failure with preserved left ventricular ejection fraction has replaced that of diastolic heart failure. It is today the most frequent presentation of heart failure because of the progressive aging of the population. Its prognosis appears to be similar to that of heart failure with reduced systolic function. B type natriuretic peptide dosing as well as doppler-echocardiography are useful for the diagnosis. Today, no treatment has revealed effective but clinical trials have been scarce. Renin-angiotensin system antagonists have promising properties but haven't shown efficacy. This article reviews the epidemiologic, diagnostic, pathophysiologic and therapeutic aspects of the disease.