Heart failure readmissions (HFR) represent a personal burden for patients and a large financial burden for the healthcare system. As such, strategies to decrease HFR are avidly sought and studied. There are many reasons for HFR that challenge programs aimed to reduce the frequency of HFR. Large pharmacological and device trials often incorporate hospital admission as an endpoint, and many programs have been developed in varied settings to address HFR. Some of the most successful programs use a multidisciplinary team approach, intensive patient education and system commitment. Many risk factors for HFR have been identified although prediction tools are limited. The reduction of HFR should incorporate a multidisciplinary approach with 1) evidenced-based physician-guided medical and device therapy; 2) institutional programs for effective care transitions; 3) strategies aimed to improve disease management; and 4) engage patients in self-care.