Heart failure with preserved ejection fraction (HFpEF) is a complex pathology that has undergone a paradigm shift in the last few years. As technology develops and diagnosis algorithms become more refined, early diagnosis leads to prompt medical management. This management has also changed in recent years. Moreover, HFpEF phenotyping attempts further nuance the management of patients with this disease. Whereas guidelines are not so firm on the medical classes of drugs that should be employed in HFpEF compared to HFrEF, new trials are on the way to change this. This literature review focuses on the evolution of diagnosis criteria for HFpEF, the clinical scores proposed by current guidelines, and also on the medical management of this pathology, focusing on medical management and how it has changed recently, by highlighting landmark trials that have been published on the topic or that are going to be published on the topic.