Background. Chronic heart failure is a leading cause of hospitalization among adults and the elderly. In heart failure, the progressive use of multiple drugs is common and recommended by international guidelines. With chronic heart failure being a common disease in the elderly, patients often have numerous comorbidities that require additional specific treatment, thus producing a heavy pill burden. On the other hand, physicians due to fear of polypragmasia, often do not prescribe drugs that should be use to improve the prognosis, life expectancy and quality of life. Objectives. To review the literature on polypragmasia risk factors. To search for methods to reduce polypragmasia risk factors in elderly with chronic heart failure. Method. Pubmed, and Embase were searched to identify articles published from 2011 to 2021. Articles reporting on the problem of polypragmasia, the current definition of the term, risk factors in elderly and senile patients were considered. Results. There are many definition of the polypragmasia but there is no consensus on this problem. In recent times, there are many good approaches for early detecting polypragmasia, for example, GerontoNet-scale, STOPP/START criteria. There are several risk factors that can lead to polypharmacy, but there is no complex approach to this issue, especially in older patients. Conclusion. The prevalence of polypharmacy is increasing worldwide. However, methods to assess risk factors of polypharmacy should be refined. Results of the literature review revealed that polypharmacy continues to be a significant issue, especially in elderly and senile age. Future studies should work toward this approach in the face of rising multimorbidity and population aging. These findings assert the need for interventions that optimize the balance of benefits and harms in medicines prescribing for eldery and senile patients with chronic heart failure.