Activation of the naturiuretic peptide system is a hallmark of heart failure (HF). In this paper the authors review aspects of the structure, regulation and physiology of the natriuretic peptides. The role of natriuretic peptides in HF progression is discussed. Potential clinical applications of BNP include diagnostic and prognosis in HF and myocardial infarction, as well as therapeutic monitoring of HF patients. Finally we review the therapeutic use of BNP.