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Iron deficiency is present in approximately 50% of patients with symptomatic heart failure and is independently associated with worse functional capacity, lower quality of, life and increased mortality. The purpose of this document is to summarize current knowledge of how iron deficiency is defined in heart failure and its epidemiology and pathophysiology, as well as pharmacological considerations for repletion strategies. This document also summarizes the rapidly expanding array of clinical trial evidence informing when, how, and in whom to consider iron repletion. • Iron deficiency is a common co-mobridity in patients with heart failure. • The use of intravenous iron therapy has demonstrated improvement in quality of life and reduced readmissions. • Further research is needed to determine is needed to determine if this leads to improvement mortality or in all subsets of heart failure, such as preserved ejection fraction. [ABSTRACT FROM AUTHOR]