Right ventricular failure (RVF) is a complicated syndrome with multiple etiologies. RVF relates to pulmonary hypertension, left ventricle failure, and congenital heart diseases. The origin of its pathway is based on pathological gene expression and concomitant diseases. Diagnosis of RVF is a serious problem for clinicians, but none of the criteria in current clinical practice provides uncontaminated information on either systolic or diastolic function. Perioperative assessment and bedside monitoring of right ventricle function have to be revised and widely used. Right ventricle function in transplant patients demands different evaluation using biomarkers or/and autopsy. Treatment of RVF has surgical and non-surgical approaches; both are still in development and need further clarification.