Each year, nearly one million patients in the United States are hospitalized with acute decompensated heart failure (ADHF). In the past, there have been limited practice guidelines for the emergency management of ADHF within the spectrum of heart failure. Data from the ADHERE (the acute decompensated heart failure national registry),indicates that these patients are repeatedly hospitalized, and otherwise have a very high rate of morbidity and mortality. The management and care of this patient group remains suboptimal. This CME activity will review the latest diagnostic and therapeutic modalities for ADHF and suggest methods to improve the care for these patients at your institution. Insights and lessons from ADHERE will also be reviewed and discussed.