Dyspepsia is a highly prevalent disorder of the upper gastrointestinal tract that affects up to 20% of the world's population over the course of the year. Risk factors for the development of dyspepsia include tobacco use, medications (e.g., anti-inflammatory agents), a previous gastrointestinal infection, and female gender. The pathophysiology of dyspepsia is complex, incompletely understood and likely varies from patient to patient. Patients with dyspepsia commonly report symptoms of epigastric pain, burning or discomfort, in addition to symptoms of early satiety, postprandial fullness, bloating, and nausea. Unfortunately, the classic symptoms of dyspepsia are quite non-specific, which means that clinicians need to be thorough, thoughtful, and logical in their diagnostic approach. Common etiologies of dyspepsia include Helicobacter pylori infection, gastritis, esophagitis, undiagnosed gastroesophageal reflux disease, peptic ulcer disease, and medication use/abuse. These etiologies account for approximately 20-25% of all cases of dyspepsia. However, the majority of dyspeptic patients, once investigated, do not have any evidence of an organic disorder and can be properly classified as having functional dyspepsia (FD). FD is defined by symptoms that have been present for at least 6 months and active within the past 3 months. The Rome IV criteria, in conjunction with a careful history and physical examination, can be used to accurately diagnose patients with FD. This review will use a case-based approach with a series of sequential key steps that will enable clinicians to accurately diagnose FD in a cost-effective manner.