It is now clear that continued stimulation o f the neurohormonal system in heart failure (HF) has serious deleterious effects on the heart. The increase of circulating catecholamines exerts direct toxic ef fect on cardiac myocytes, increases membrane permeability and myocardial fibrosi s; lead to aggravation of HF. β-blockers are commonly used in the treatment of HF including propranolol, metoprolol, bisoprolol, bucindolol and carvedilol. These drugs are used in combination with ACEIs, digitalis and diuretics. Genera lly, the benefits of β-blockade therapy in HF include improving symptoms, decr easing morbidity, mortality, elevating need for hospitalization and quality of l ife. β- blockade therapy arrests and reverts LV remodeling and improves the ri sk of life threatening arrhythmias and sudden cardiac death. A few serious adver se effects include hypotension, heart blocks, bradycardia and fluid retention.