Abstract: Heart failure (HF) is the end-stage of cardiovascular disease progression and seriously affects the quality of survival and prognosis of patients. In recent years, heart failure with preserved ejection fraction (HFpEF) accounts for approximately 50% of all HF cases and it is increasingly becoming a global health problem. The left atrium is critical for regulating left ventricular filling volume and maintaining whole heart function and recent studies have found that left atrial function plays an important role in the development and progression of HFpEF and is independently associated with a poor prognosis of HFpEF. Therefore, this article reviews the relationship between HFpEF and left atrial structure and function, with the aim of further understanding the importance of left atrial structure and function in the diagnosis and evaluation of patients with HFpEF.