Brucella endocarditis is a rare but fatal manifestation of brucellosis. Delayed diagnosis often leads to serious complications such as extensive valvular destruction. Traditional diagnostic methods have limited accuracy; therefore, the use of advanced diagnostic techniques is recommended. This review evaluates traditional, molecular, and advanced diagnostic techniques for the diagnosis of Brucella endocarditis, including blood culture, tissue and valve cultures, serology, Shell Vial assay, FDG PET/CT, cardiac CT, and MRI. Traditional techniques, such as blood culture and echocardiography, have limited sensitivity in the early diagnosis of Brucella endocarditis, while advanced techniques, such as PCR, next-generation sequencing, FDG PET/CT, cardiac CT, and MRI, can detect hidden lesions, paravalvular infections, and culture-negative infections with high accuracy in difficult cases such as. The review includes studies related to blood culture, tissue and valve cultures, serology, Shell Vial assay, FDG PET/CT, cardiac CT, and MRI. The combination of advanced techniques with traditional approaches can help form a more complete diagnostic pathway and improve clinical outcomes. In conclusion, early and accurate diagnosis is important for clinical interventions, prevention of complications and decrease mortality. Wider access to modern molecular and imaging tools in endemic regions and high-quality studies on advanced diagnosis are needed for improvement of Brucella endocarditis survival outcomes. A structured, multimodality diagnostic strategy can have a key role in reducing mortality and improving long-term outcomes in patients with Brucella endocarditis.