The progressive nature of PAH, and the poor prognosis it carries for most patients, provides clinical rationale for an aggressive approach to disease management. Recent real-world data from three European PAH registries support the prognostic utility of risk stratification outlined in the 2015 ESC/ERS treatment guidelines. These results emphasize that disease stabilization may not be sufficient for all patients. Experts in PAH treatment will discuss current risk assessment strategies and their implementation in clinical practice to support a goal-oriented approach in the treatment of PAH.