In the last 40 years, pharmacological therapy for chronic heart failure has rapidly expanded beyond diuretics and digoxin. Standard pharmacological therapy includes beta blockers and renin-angiotensin-aldosterone system antagonists. Even with existing contemporary pharmacological therapy, which has substantially improved outcomes, prognosis is fairly poor. The treatment of heart failure continues to evolve with the integration of the results from landmark clinical trials into contemporary therapy. Development of novel therapeutic strategies for the treatment of this disease is crucial. Some of these new approaches will be briefly discussed.