Brain natriuretic peptide (BNP) is a counter-regulatory hormone produced mainly by ventricular myocardium. Early research studies were performed to ascertain its value in the diagnosis of congestive heart failure in acute care settings. Subsequent studies have explored its utility in screening for asymptomatic left ventricular dysfunction in the community, determining prognosis in coronary artery disease, appropriate timing of surgery in valve disorders, and in evaluating many other cardiac diseases. This review summarizes the current status of medical literature, introduces a new test to the insurance industry.