This article provides a comprehensive overview of heart failure, focusing on its pathophysiology and contemporary therapeutic approaches. Heart failure is a complex clinical syndrome caused by structural or functional cardiac abnormalities that impair the heart’s ability to pump blood effectively. The article reviews hemodynamic changes, neurohormonal activation, cellular remodeling, and molecular mechanisms underlying the disease. It also examines modern treatment strategies, including pharmacological therapy, lifestyle modifications, device-based interventions, and surgical options. Emphasis is placed on integrating clinical insights with recent research to improve patient outcomes, quality of life, and prognosis.