The United States population, particularly among older age groups, continues to expand. Because the incidence of heart failure increases with age, largely due to the development of heart failure risk factors such as hypertension and coronary artery disease, the epidemic of heart failure is likely to grow further in the coming decades. This article will review the epidemiology of heart failure among older adults, the influence of an aging population on heart failure prevalence and phenotype, the complications in management for a larger and older heart failure population, and the potential implications of these changes for health care costs and delivery. Ultimately, these challenges demand research into optimal therapeutic strategies for older heart failure patients, including improved prevention and treatment of the major causes of heart failure, an increasing role forpalliative care, and innovations in patient-centered health care delivery.