Left heart disease is an important cause of pulmonary hypertension, including left heart systolic insufficiency, diastolic insufficiency and heart valve disease. Left heart failure causes pulmonary hypertension mainly because of left heart systolic insufficiency. For left heart disease leading to pulmonary hypertension its pathophysiological changes are more complex, mainly manifested as elevated hydrostatic pressure, which originates from elevated left ventricular end-diastolic pressure and passive backward transmission of the elevated pressure. Increased vascular reactivity refers to increased pulmonary artery tone and obstructive remodeling of fixed structures of the pulmonary resistance vessels. Clinical manifestations are mainly those of left heart disease, with telentery and nocturnal paroxysmal dyspnea being its specific clinical manifestations compared to other types of pulmonary hypertension. The principle of treatment for pulmonary hypertension due to left heart disease is to treat the left heart disease first, and commonly used drugs include diuretics, angiotensin-converting enzyme inhibitors, and beta-receptor antagonists. In case of heart valve disease, surgical procedures should be performed.