Despite improvements in health care, the incidence of infective endocarditis has not decreased over the past decades. Infective endocarditis is lethal if not aggressively treated with antibiotics, combined or not with surgery. Developments in antibacterial therapy, clinical microbiology, cardiac imaging, and cardiac surgery have revolutionised its diagnosis and prognosis. In this section, we review and update the current literature with respect to pathophysiology, diagnostic challenges and strategies, and management choices in patients with IE