Despite recent advances in the diagnosis and treatment of cardiovascular disease, the prevalence of heart failure, a highly morbid and lethal condition, is increasing. Because of recent advances in basic and clinical research, beta-blockade is now established as a highly effective therapy that reduces morbidity and mortality dramatically in patients with heart failure associated with reduced systolic function. The new guidelines from the American College of Cardiology-American Heart Association recommend use of beta-blockers in all patients with symptomatic left ventricular systolic dysfunction. Now clinicians need to incorporate use of beta-blockers into their standard approach to the treatment of heart failure. We briefly summarize the basic and clinical evidence establishing the benefit of beta-blockers for heart failure and provide practical information to assist clinicians in deciding when and how to use beta-blockers in patients with heart failure.