Beta-adrenergic receptor blockers are effective in reducing morbidity and mortality in heart failure. These drugs slow the progression of heart failure by modifying the remodeling process, prevent or delay need for hospital admission for heart failure. They reduce both pump failure and sudden arrhythmic death. There are many patients that do not receive beta blocker therapy in the heart failure population. Patients are often treated with beta blockers not tested in clinical trials to demonstrate efficacy in this patient population. Results from the recently published trials are summarized to emphasize the proper selection and dosage of beta blocker therapy to optimize the care of this high risk population.