Abnormal diastolic function is increasingly appreciated as a major contributor to cardiac morbidity and mortality. Accurate noninvasive assessment of the presence and severity of diastolic impairment is crucial to the broad application and understanding of this common condition. Echocardiographic parameters have become the backbone of this noninvasive assessment. Active investigation into both old and new Doppler variables will provide the framework that can lead to a more uniform assessment and reporting that will be essential as we prepare to confront clinically the next frontier in cardiac pathophysiology. This review discusses the clinical impact of recent echocardiographic contributions to the field of diastology.