Myeloproliferative neoplasms (MPNs) encompass a heterogeneous group of chronic, clonal haematopoietic stem cell neoplasms that harbor the propensity to undergo leukaemic transformation. Epidemiological data on MPNs especially pertaining to non-Caucasian populations is limited, and the molecular pathogenesis of MPN remains unclear. Although the discovery of MPN driver mutations in JAK2, MPL and CALR in the last decade has revolutionised disease management, the mutations are not specific for any MPN subtype. The management of MPNs is further challenged by substantial genetic and phenotypic heterogeneity that exist between and within MPN subtypes as well as other myeloid diseases. In this review, we focus on the classical Philadelphia chromosome (Ph)-negative MPNs – polycythaemia vera (PV), essential thrombocythaemia (ET), and primary myelofibrosis (PMF); providing an overview on the current understanding of the disease at a clinical and molecular standpoint while discussing the present challenges and future opportunities in the management of MPNs.