This article reviews the results of observational statin use in clinical trials of patients who have systolic heart failure, in post-myocardial infarction with left ventricular dysfunction, and in cardiac device trials. This article shows a consistent benefit of statins on mortality (approximately 25%) in heart failure patients of both ischemic and nonischemic etiology. The benefit is not altered by concomitant heart failure medications or device therapy. The benefit of statins in heart failure is being investigated in large prospective trials in a broad range of heart failure patients.