This article provides a comprehensive review of contemporary approaches to the care of cardiogenic shock (CS), a complex syndrome characterized by profound circulatory collapse due to impaired myocardial contractility. The authors discuss the pathophysiology, epidemiology, and clinical presentations of CS, emphasizing the increasing prevalence of non-AMI CS. They highlight the importance of early revascularization and standardized, team-based care, including the use of pulmonary artery catheter (PAC) hemodynamic monitoring and temporary mechanical circulatory support (tMCS) devices. The article also reviews the evolution of CS classification systems, such as the SCAI five-stage classification, and the role of multidisciplinary "shock teams" in improving patient outcomes. Additionally, it covers emergency department care, vascular access strategies, antithrombotic therapy, revascularization strategies, and the management of heart failure-related CS. The authors emphasize the importance of invasive hemodynamic monitoring and the use of tMCS devices, while also discussing the ongoing challenges and controversies in CS management. The article concludes with a discussion of future research directions and the need for continued advancements in CS care.This article provides a comprehensive review of contemporary approaches to the care of cardiogenic shock (CS), a complex syndrome characterized by profound circulatory collapse due to impaired myocardial contractility. The authors discuss the pathophysiology, epidemiology, and clinical presentations of CS, emphasizing the increasing prevalence of non-AMI CS. They highlight the importance of early revascularization and standardized, team-based care, including the use of pulmonary artery catheter (PAC) hemodynamic monitoring and temporary mechanical circulatory support (tMCS) devices. The article also reviews the evolution of CS classification systems, such as the SCAI five-stage classification, and the role of multidisciplinary "shock teams" in improving patient outcomes. Additionally, it covers emergency department care, vascular access strategies, antithrombotic therapy, revascularization strategies, and the management of heart failure-related CS. The authors emphasize the importance of invasive hemodynamic monitoring and the use of tMCS devices, while also discussing the ongoing challenges and controversies in CS management. The article concludes with a discussion of future research directions and the need for continued advancements in CS care.