Heart failure remains a significant health problem in the United States and in the world.Despite a surfeit of recent diagnostic and therapeutic advances,patients with heart failure remain inadequately helped.The overwhelming need for new and better therapies continues to stimulate scientists to investigate new technologies.Over the past several years the use of enhanced external counterpulsation as a treatment for chronic angina has steadily increased.Recently,its potential role in heart failure management has been shown.We review the role of enhanced external counterpulsation in heart failure management as an emerging noninvasive outpatient therapy.