Heart failure has contributed to a rising mortality and hospitalization rate in the past decades despite several breakthrough discoveries and advances in its management. Approximately 50% of all patients with Heart failure have heart failure with reduced ejection fraction. Different etiologies and pathogenesis pose a challenge in finding the optimal management for heart failure with reduced ejection fraction. Albeit these challenges posed, over the years there have been recent advancement in the pharmacotherapy of heart failure with reduced ejection fraction with recent breakthroughs and new additions to the guideline directed therapy involving drugs like ARNI ( Neprilysin inhibitor and Valsartan combination), Omecamtiv Mecarbil (a cardiac myosin activator that improves myocardial function by augmenting cardiac sarcomere function), Vericiguat (an oral soluble guanylate cyclase stimulator) and even SGLT2 inhibitors which is usually used in type 2 diabetes patient have been found to be useful in reducing mortality. More studies are being conducted on several drugs and other alternatives such as gene therapy which may help treat the disease are being explored. Additionally, the future is bright with exciting and promising therapeutic options waiting to be discovered.