At present, a constant progress in pathophysiology understanding and treatment of the chronic heart failure (CHF) is arising. The current CHF pharmacotherapy is complex, involving factors affecting the reninangiotensin- aldosterone system (RAAS), β-blockers, diuretics and vasodilatators. There are also significant efforts to introduce in CHF pharmacology novel therapeutic strategies, based on the other neurohormonal mechanisms activated in CHF. They include vasopressin receptor antagonists (VRA; vaptans), endothelin receptor antagonists (ERA; sentans), agents relating to the natriuretic peptides system (neutral endopeptidase inhibitors; NEPI and vasopeptidase inhibitors; VPI) and anticytokines agents (anti TNF-α immunoglobulin or TNF-α scavenger receptor; Etanercept). In this article we briefly describe the modern approach to CHF systemic treatment