The aim of this study is to describe improvements in survival of patients with heart failure. In addition, factors that may have contributed to these improvements are discussed. The extent of improvement in survival is substantial. This is presumably mainly due to a broad spectrum of new therapeutic options and the introduction of clinical guidelines, and the increasing level of awareness and adherence. For the near future, the increasing implementation of disease management programs and complex interventions has the potential to have a further positive influence on the survival of patients with heart failure.