Congestive heart failure describes the syndrome that occurs when the heart is unable to pump enough blood to meet the oxygen and nutrient demands of the body. The decreased cardiac output results in decrease renal blood perfusion and therefore decreased fluid excretion. The accumulated fluid deposits around certain organs producing symptoms of congestion. These include pitting edema, ascites, pulmonary edema and jugular vein distension amongst others. The syndrome is caused by many disease such as congenital heart disease, valvular disease, cardiomyopathy, coronary artery disease, arrhythmias, amyloidosis, hypertension and any other pathology affecting the cardiac musculature. Patients would complain of dyspnea and exercise intolerance, orthopnea. Rales and crackles may be felt on lung percussion and a murmur, may be heard on auscultation of the heart. A laterally displaced apex beat and a gallop rhythm are also suggestive of heart failure. The signs of congestion may also be observed in a patient. Diagnosis is based on clinical manifestation and a physical examination together with history taking is essential. An ECG, echocardiography, chest x-ray and blood test help to confirm the diagnosis. Management guidelines classify the patient into four stages as stated by the ACCF/AHA treatment guidelines. In stage A, these patients are at a high risk of heart failure though they have no structural heart abnormality and present with no symptoms. Management goals is to prevent heart failure by change in lifestyle and use of drugs such as statins, ACE inhibitors or ARBs. Stage B patients who have a structural heart disease but no heart failure symptoms may be given ACE inhibitors, ARBs, and beta blockers. Certain interventions such as putting an intracardiac device or other measures to prevent further cardiac remodelling may be applied. Stage C patients who have a structural heart disease and present with symptoms of heart failure are treated with all the drugs used in a stage B patient along with diuretics and revascularization or vascular surgery if needed. Stage D patients who have refractory heart failure are treated as their counterparts in the latter stages. They are also given vasodilators, aldosterone antagonists, chronic ionotrope therapy, mechanical circulatory support and palliative care when necessary. Some of the drugs used in heart failure include diuretics which reduce the fluid overload. Angiotensin antagonists such as ACE inhibitors, and ARBs help to reduce aldosterone and salt and water concentration in the body. Beta blockers are used when systolic dysfunction is severely impaired, they decrease the progression of heart failure. Phosphodiesterase inhibitors 5 cause vasodilation which is beneficial to counteract the vasoconstriction caused by the disease. Vasodilator drugs such as nitroglycerin and nitroprusside help to decrease preload and afterload. Cardiac glycosides which help to improve the contractility of the heart may also be used in refractory heart failure. This thesis discusses congestive heart failure; its etiology, epidemiology, pathophysiology, signs and symptoms, diagnosis and management.