Along with the further aging of Chinese population, the number of elderly patients with heart failure is mounting rapidly, while hemodynamic monitoring plays an important role in the treatment of elderly patients with complex hemodynamic states and multiple diseases. Pulse indicated continuous cardiac output (PICCO) can quickly, effectively, continuously and safely perform hemodynamic monitoring and guide precise treatment, which is of great practical significance for improving the quality of life, prognosis and prolonging the effective life time of elderly patients with heart failure. This article reviews the characteristics of senile heart failure, the clinical application, safety and characteristics of PICCO.