Recent years have seen an increase in global, multisoci-ety, consensus-driven guidelines and position papers. These initiatives are a particularly important mechanism of pro-viding a practical and broadly credible approach to common problems that have defied common description and to uncommon scenarios where a large heterogeneity of clinical practice occurs, even in highly specialized, tertiary care set-tings. The recently published Universal Definition of Heart Failure is a prime example of the former condition,1 whereas the Position Statement of Endomyocardial Biopsy (EMB) published in this issue of the Journal is a corre-sponding example of the latter.2 Here, we discuss the evolu-tion of EMB from a single-indication test to its subsequent expansion and, more recently, to refinements of indication, performance and clinical value.