Various pharmacologic options exist for patients with PAH. Their overall effect on the disease is modest; however, with proper selection and monitoring they can improve symptoms and improve the quality and duration of life. Patient education is vital to ensure the proper use of these medications. Initial and continued responses vary greatly between patients necessitating trials of several different medications for some patients to achieve optimal outcomes. While newer agents may be better tolerated than older ones, improved efficacy has not yet been observed. In the future, improved outcomes may rely on determining optimal combination strategies.