The spectrum of pulmonary vascular diseases includes pulmonary arterial hypertension, chronic thromboembolic pulmonary hypertension, and pulmonary veno-occlusive disease, each requiring distinct diagnostic and therapeutic pathways. Advancements in echocardiography, right heart catheterization, and cardiopulmonary exercise testing have improved disease characterization. Targeted therapies—such as endothelin receptor antagonists, phosphodiesterase inhibitors, and prostacyclin analogs—are central to modifying disease trajectory and enhancing exercise tolerance. Pulmonary Vascular Diseases also benefit from emerging research in vascular remodeling, endothelial dysfunction, and right ventricular adaptation. Surgical interventions, including pulmonary thromboendarterectomy and balloon pulmonary angioplasty, offer curative potential in select cases. Increasing awareness, earlier screening, and multidisciplinary coordination between pulmonology and cardiology are essential for optimizing care