Pulmonary arterial hypertension (PAH) is a serious, progressive condition and successfully managing patients can present certain challenges. Treatment selection is multifactorial and often involves the consideration of myriad patient factors, including WHO Group, objective risk stratification score, cardiac functioning on imaging, and shared decision-making. And while all patients who are living with PAH require careful evaluation, those with comorbidities and/or psychosocial challenges can require additional consideration when developing a treatment plan that improves outcomes.