The natural course of Duchenne muscular dystrophy is one of steady, progressive muscle weakness, with most individuals losing the ability to walk independently by around age twelve, though the age at which this happens, and the pace of decline afterward, vary somewhat from person to person and can be meaningfully slowed by corticosteroid treatment. Historically, survival beyond the third decade of life was unusual, but with modern multidisciplinary care, particularly proactive respiratory and cardiac management, median survival has extended into the late twenties and beyond, with some individuals living well into their thirties or longer. Respiratory failure and progressive heart muscle disease remain the most common causes of death.

Because the disease affects several body systems and changes in character over time, from early childhood through the teenage and young adult years, ongoing surveillance across specialties is recommended for life.
• Cardiac: a full cardiac evaluation, including an electrocardiogram and an imaging study such as echocardiography, is recommended at least every two years starting at diagnosis, moving to annual evaluation from around age ten or with the onset of any cardiac symptoms, and every six months if reduced heart function is found.
• Pulmonary: baseline lung function testing is obtained before an individual becomes wheelchair dependent, typically around age nine or ten, with evaluation by a lung specialist at least twice yearly once they are using a wheelchair, once lung capacity falls below eighty percent of the expected value, or by age twelve, whichever comes first.
• Orthopedic: regular monitoring for scoliosis and joint contractures, with bracing or surgical referral as needed.
• Bone health: periodic blood and urine testing, along with bone density scanning, particularly for those on long-term corticosteroid treatment or with a history of fractures.
• Growth and nutrition: assessed regularly, especially around the start of corticosteroid therapy or if swallowing difficulties develop.
• Carrier females: even without symptoms, female carriers of a DMD genetic change face an increased lifetime risk of heart muscle disease and are recommended to begin cardiac screening in late adolescence or early adulthood, with regular follow-up at least every five years starting around age twenty-five to thirty.
Referral to a comprehensive neuromuscular clinic, where neurology, cardiology, pulmonology, orthopedics, physical therapy, and genetic counseling are coordinated, is strongly recommended for every affected individual and family.