Infective endocarditis is defined as infection of the cardiac endothelium, seen as vegetations that threats life despite the progress of modern medical and surgical therapy. The mortality rates of this disease ranges from 20% to 30% for both native and prosthetic valve endocarditis (PVE) and may increases to reach 70% in certain high-risk patients. The clinical diagnosis based on multiple elements, and best managed via collaboration among cardiologists, cardiothoracic surgeons, and infection disease specialists. The diagnosis of infectious endocarditis requires multiple clinical, laboratory, and imaging findings. The widely accepted Duke criteria use a set of major and minor clinical and pathologic criteria to classify infectious endocarditis as definite, possible, or rejected. IE is one of the life-threatening complications of parenteral drug abuse as it affects intravenous drug abusers (IVDUs) by a ratio ranging from 2% to 5% annually. In addition, it is the reason for 5% to 20% of hospitalized cases and 5% to 10% of the overall mortality rate. IVDUs often develop recurrent IE. Right side infective endocarditis has been mainly defined among IVDUs. The infective endocarditis epidemiology has changed recently, which reflects the social climate of IV drug use. This changing epidemiology changed in turn the standard treatments for this type of infection. It requires a more holistic study to shed light on the diverse needs of this clinical population. The rate of right-heart IE occurrence among IVDU may vary from 0.7 to 13/1000 patient annually.