Endomyocardial fibrosis (EMF) is an idiopathic disorder of the tropical and subtropical regions of the world. It is the commonest cause of restrictive cardiomyopathy and affects an estimated 10 million people worldwide mainly children and adolescents from Africa, South America, and Asia.The etiology and pathogenesis of EMF remain unknown, since none of the factors that have been postulated for its origin can fully explain the occurrence worldwide. EMF might be caused by one or several environmental factors acting upon genetically predisposed individuals. Attempts to relate the condition to infections, dietary factors, and toxic agents failed to unveil the exact etiology and pathogenesis.