This article is a review of the pharmacologic management of congestive heart failure (CHF) and a summary of the medical literature that guides current treatment strategies. Despite advances in the treatment of CHF, it remains a common diagnosis with a poor prognosis. Because CHF is a progressive syndrome with heterogeneous features of cardiac dysfunction, effective management requires combination therapies and evolving treatment strategies. The mechanism of action, goals of therapy, and demonstrated efficacy of each of the various agents used in the treatment of CHF are discussed.