Right ventricular physiology is characterized by its close relationship with the pulmonary circuit. The right ventricle can accommodate significant changes in preload, but is highly sensitive to increases in afterload. Progressive dilatation and dysfunction can initiate a cycle of oxygen supply-demand mismatch that ultimately leads to right ventricular failure. Echocardiography and cardiac magnetic resonance imaging are the primary modalities used for non-invasive assessment of right ventricular function. The management of right ventricular failure centers on the optimization of preload, afterload and contractility. Few targeted therapies exist, although novel agents have shown promise in early studies.