The incidence of premature ventricular contractions (PVCs) in a structurally normal heart can result in clinically significant consequences, including PVC-induced cardiomyopathy. It is essential to consider the electrophysiologic characteristics of the PVCs to determine the patient's susceptibility. In an asymptomatic patient with no other structural heart disease and with PVCs, it is crucial to understand both the prognostic significance of the PVCs and when to initiate treatment with the appropriate modality. This review aims to review the clinical significance of PVCs in a normal heart and discuss the appropriate timing of treatment and first-line therapy.