Background. Heart failure is the most common cardiovascular reason for hospital admission for people older than 60 years of age. Chronic heart failure is the final stage in several heart diseases. The diagnosis and the treatment of chronic heart failure in older and senile patients is a challenge. Pharmacological management of heart failure in the elderly remains a challenge. The syndrome of heart failure cannot be isolated from other comorbidities, which are very common in this population. Objectives. The purpose of this review the literature on features of diagnosis and treatment of chronic heart failure in older age groups is to assist practicing clinicians to more effectively make decisions about management of heart failure in the elderly. Method. Articles reporting on the problem of problem of diagnosis and treatment of chronic heart failure 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. Diagnosis and treatment of patients of chronic heart failure in older age groups must be carried out into age characteristics. HF therapy that has published mortality and morbidity benefits in nonelderly patient has been associated with no benefits in elderly patients. In general, the elderly patient with heart failure should be treated according to current heart failure guidelines, but a comprehensive individualized approach should be used in this group.