Chronic heart failure is an epidemic disorder in the elderly population. The frequent coexistence of comorbid illnesses and psychosocial issues in older persons often makes diagnosis and management difficult. Physicians must be aware of the current diagnostic modalities and proven therapies as they apply to elderly patients in order to achieve optimal outcomes. This article reviews new approaches to the diagnosis of heart failure, and discusses the latest evidence for both pharmacologic and nonpharmacologic treatment for this condition. Multidisciplinary strategies for the management of heart failure and end-of-life care are also briefly discussed.