The European Malignant Hyperthermia Group has introduced a dual-track diagnostic approach that adds genetic testing alongside the established halothane/caffeine contracture test for identifying patients at risk of this potentially fatal anesthetic reaction. The updated protocol introduces "MH genotype" as a new diagnostic category and includes a refined variant curation system for interpreting genetic mutations related to hyperthermia susceptibility. This represents the most significant evolution in malignant hyperthermia diagnostics since DNA-based testing became clinically viable. The integration of genetic screening addresses a critical gap in patient safety protocols, particularly for family members of affected individuals who may carry risk variants without prior anesthetic exposure. While the traditional muscle biopsy contracture test remains the diagnostic gold standard, genetic testing offers a less invasive screening option that could identify at-risk patients earlier in their medical care. The guidelines reflect growing confidence in genomic medicine's ability to predict drug reactions, though the clinical utility will depend on how comprehensively the genetic variant database captures the full spectrum of susceptibility mutations across diverse populations.