Transthyretin amyloid cardiomyopathy (ATTR-CM) resulting from deposition of transthyretin amyloid fibrils in the heart is an underrecognised cause of heart failure in the elderly and is associated with a poor life expectancy. The diagnosis can now be made by radionuclide imaging with bone tracers, provided absence of plasma-cell dyscrasia. Recent evidence has suggested a considerable prevalence of ATTR-CM, and effective treatment has become available. This review summarises these new developments, which have ushered a new era in the detection and clinical management of ATTR-CM.