Heart failure (HF) is a common and major disease in the elderly, in whom, the structures and functions of cardiac and other systems are degraded, and the cardiac reserve capacity is decreased. So, they are susceptible to hypertension, coronary heart diseases and other cardiovascular diseases and commonly accompanied with multi-organ diseases. When they suffer from infection, myocardial ischemia or other inducing factors, they are prone to HF. Because of the complicated, various and even atypical clinical signs and symptoms, the HF is easily misdiagnosed or missed in the elderly. It is of great importance to make a timely and accurate diagnosis and treatment. Comprehensive treatment measures should be carried out for the elderly with HF and be based on personalized therapeutic principle. It is necessary to strengthen the guidance of treatment and management, to relieve the symptoms, and improve quality of life and prognosis in the involved ones.