Compliance with a complex healthcare regimen is required of most patients with heart failure. Noncompliance with even some aspects of the recommended treatment can lead to repeated and preventable hospitalizations, or even death. This paper reviews the extent of noncompliance for general health-seeking behavior and recommended lifestyle modifications in the general population, as well as the research on compliance conducted specifically in patients with heart failure. Research findings are reviewed in three areas: the extent and predictors of compliance, the relationship of compliance and clinical outcomes, and interventions designed to increase compliance in heart failure patients. Based on research findings to date, strategies to enhance compliance are offered.