Extravascular lung water is a crucial parameter for the management of many different pathological conditions, especially heart failure. Many modalities can be employed for its evaluation, each with different advantages and limitations. In a near future, we hope that extravascular lung water assessment could be performed by non-invasive wearable devices, allowing remote continuous monitoring of pulmonary congestion. Recently, it has been proposed that some specific genetic variations may be responsible for the heterogeneous individual response to the development of extravascular lung water. These data could be relevant to titrate and personalize both treatments and preventive interventions.