Abstract: Nuclear cardiology is the most commonly performed non-invasive cardiac imaging test in patients with heart failure, and it plays an important role in their assessment and management.Quantitative gated single positron emission computed tomography is used to assess quantitatively cardiac volume, left ventricular ejection fraction, stroke volume, and cardiac diastolic function.Resting and stress myocardial perfu-sion imaging can not only identify nonischemic heart failure and ischemic heart failure, but aslo demonstrat myocardial viability.Diastolic heart failure aslo termed as heart failure with a preserved left ventricular ejection fraction is readily identified by nuclear cardiology techniques and can accurately be estimated by peak filling rate and time to peak filling rate.With newer techniques such as three-dimensional, quantitative gated single positron emission computed tomography can assess movement of the left ventricle, and wall thickening evaluation aids its assessment.Myocardial perfusion imaging is also commonly used to identify candidates for implantable cardiac defibrillator and cardiac resynchronization therapies.Neurotransmitter imaging using ¹²³I-metaiodobenzylguanidine offers prognostic information in patients with heart failure. Metabolism and function in the heart are closely related, and energy substrate metabolism is a potential target of medical therapies to improve cardiac function in patients with heart failure.Cardiac metabolic imaging using ¹²³I-15-(p-iodophenyl)3-R, S-methylpentadecacoic acid is a commonly used tracer in clinical studies to diagnose metabolic heart failure.Nuclear cardiology tests, including neurotransmitter imaging and metabolic imaging, are now easily preformed with new tracers to improve heart failure diagnosis.Nuclear cardiology techniques contribute significantly to identifying patients with heart failure and to guiding their management decisions.