Even though frequently asymptomatic, for some patients calcium pyrophosphate crystal deposition remains a troublesome disorder; these patients can present with recurrent episodes of painful monoarthritis, with persistent polyarticular inflammation or with mechanical joint pain and osteoarthritic changes. The features of the disease may mimic other rheumatic and nonrheumatic conditions, with misdiagnosis being a common problem. Frequently, calcium pyrophosphate crystal deposition is discovered through the incidental finding of chondrocalcinosis on x-rays. Despite being a relevant and poorly understood disorder, it has received little attention from the medical community and the flux of new insights is low when compared with other rheumatic diseases. This paper will review calcium pyrophosphate crystal deposition, stressing the significance of recent contributions in terminology, pathogenesis and management.