Among elderly adults, the most common reason for hospitalization is heart failure. Understanding the treatment options for this complex syndrome is vital to the practice of contemporary medicine. Early recognition of patients at risk for developing heart failure and the stage-appropriate management of patients with established heart failure is paramount for optimal patient care. However, the vast array of therapeutic options currently available can seem daunting. It is the aim of this review to describe the framework for approaching heart failure patients so that the physician can provide the most appropriate therapies at each stage of the disease.