Heart failure achieves particular relevance and different characteristics in the elderly population, especially for the clinical complexity related to the presence of comorbidity and chronicity, which are common conditions in these patients. Despite recent advances in clinical approach, diagnosis and therapeutic management of heart failure, the incidence and prevalence of this syndrome are still increasing, owing to the better control of the disease, and, largely, to the aging of the population. Epidemiologic data indicate that heart failure represents a crucial problem in the elderly population in terms of social, economic, and health burden. Despite their importance in the worsening of heart failure and prevention of the progression of this syndrome, the risks of hospital readmission and the causes of exacerbation have not been systematically evaluated in controlled trials. This explains why the precipitating factors of heart failure remain unknown in more than 40% of cases. For these reasons, prospective studies are needed in order to assess and clearly define the risk of hospital readmission and the causes related to heart failure exacerbation in the elderly population.