Idiopathic recurrent pericarditis (IRP) is a relatively rare inflammatory disease of the pericardium, often requiring emergency medical care, associated with a high percentage of temporary disability and significant economic costs. The review presents various points of view on the pathogenesis of recurrent pericarditis, discusses the role of autoinflammation. It touches on treatment issues based on modern data on the IRP immunopathogenesis, and considers promising areas of laboratory diagnostics.