Despite progress in medical and surgical treatment, morbidity and mortality remain high in infective endocarditis. Multiple diagnostic tools are now available to decrease delays in the diagnosis and instauration of appropriate treatment. Identification of patients at high risk of developing complications and those who may benefit from early surgery could improve prognosis and outcome. This article reviews some of the existing tools and options available for the diagnosis, risk evaluation and treatment of infective endocarditis, as well as the evidence for their systematic use.