The current status on the understanding of the various operational aspects of high temperature proton exchange membrane fuel cells (HT-PEMFC) has been summarized. The paper focuses on phosphoric acid-doped polybenzimidazole (PBI)-based HT-PEMPCs and an overview of the common practices of their design and characterization techniques at single cell, stack and system levels is given. The state-of-the-art concepts of different degradation mechanisms and methods of their mitigation are also discussed. Moreover, accelerated stress testing (AST) procedures for HT-PEMFCs available in literature are outlined. Catalyst degradation and electrolyte loss take place at higher rates in the beginning of life of the fuel cell. This is due to the smaller size of Pt particles and the presence of excess phosphoric acid in the beginning of life that favor the respective degradation. Therefore, the redistribution of phosphoric acid in the membrane and the electrodes is crucial for the proper activation of the fuel cell, and a startup procedure should take this into account in order to avoid beginning of life degradation. On-line monitoring of the fuel cell system's state of health using diagnostic tools can help detect fuel cell faults for targeted interventions based on the observed conditions to prevent sudden failures and to prolong the fuel cell's lifetime. However, the technology is still under development and robust on-line diagnostics tools are hardly available. Currently, mitigation is mainly done based on favorable operating conditions and techniques to recover degradation and the development of more resistant components that can withstand the known degradation mechanisms. (C) 2016 Hydrogen Energy Publications LLC. Published by Elsevier Ltd. All rights reserved.