Natriuretic peptide testing in the form of B-type natriuretic peptide (BNP) or NT-proBNP measurement has revolutionized modern heart failure (HF) diagnostics for those patients with acute symptoms, and promises to have similarly profound effects not only for the earlier recognition of those with HF, but also for the therapy of patients across the entire spectrum of HF. Future efforts are necessary to better understand the complex biology of the natriuretic peptides, to further optimize use of the assays for their measurement, and to gain clarity regarding the appropriate venue for their measurement. The ultimate goal is to recognize more readily and treat the syndrome that is HF, in order to reduce the considerable morbidity and mortality among those so afflicted.