Our understanding of left ventricular diastolic function has evolved with our understanding of Doppler echocardiographic assessment of left ventricular filling dynamics. Left ventricular diastolic function consists of several variables which affect the Doppler echocardiographic recordings in a complex way. While there are still limitations with the non-invasive assessment of left ventricular diastolic function and filling pressures by Doppler echocardiography, great progress has been made and careful interpretation of properly obtained Doppler recordings can give clinically relevant information concerning left ventricular diastolic function, filling pressures, and prognosis in patients with cardiac disease.