Although pharmacological therapy in heart failure is making rapid progress, the prevalence and mortality of heart failure remain high. Thus, effective non-pharmacological therapies combined with conventional therapies are essential for further improving the prognosis of heart failure. In recent years, noninvasive positive pressure ventilation (NPPV) therapy has been widely used for acute as well as chronic heart failure. This device, which is easy to wear and can be discontinued at any time, appears to have many advantages over other non-pharmacological therapies. Adaptive servo-ventilation (ASV) treatment has become common in clinical practice before large clinical trials have confirmed the prognostic superiority. Unfortunately, the large clinical trials of ASV have encountered unexpected negative results. However, could the evidence of small clinical studies cultivated so far be overwritten by large evidence? This review describes the role of NPPV therapy applied through a mask interface in the treatment of acute and chronic heart failure.