Heart failure (HF) is a complex clinical syndrome affecting multiple organs and systems, posing a significant public health concern due to its high prevalence, mortality, and medical costs. Asia, with its diverse population, ethnicities, and healthcare systems, faces unique challenges in HF prevention and management. This review aims to summarize the epidemiology, etiology, risk factors, outcomes, and management of HF in Asia, drawing from Global Burden of Disease (GBD) data and registry studies. **Epidemiology:** - The age-standardized prevalence of HF in Asia was 722.45 per 100,000 population, with China, Indonesia, and Malaysia having the highest rates. - The prevalence of HF varied across Asian regions, with East Asia having the highest rate (1,014.06 per 100,000 population) and South Asia the lowest (389.97 per 100,000 population). - The 1-year mortality rate for HF patients was highest in Indonesia (34.1%) and lowest in Korea (10.9%). **Causes and Risk Factors:** - Ischemic heart disease and hypertensive heart disease are the leading causes of HF in Asia. - Air pollution and ambient temperature variability are also significant risk factors. - Unhealthy lifestyle factors and cardiometabolic health metrics are associated with an increased risk of HF. **Outcomes:** - HF patients in Asia have high 1-year mortality rates, with cardiovascular (CV) deaths being the primary cause of death. - National-level registries in countries like Japan, Korea, and China show varying mortality and readmission rates, with CV deaths being the leading cause. **Management:** - Guideline-directed medical therapy (GDMT) is underutilized, with only a small proportion of patients receiving recommended doses of medications. - Device therapy, such as implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapies (CRTs), is also underutilized, with significant regional disparities. - Sodium-glucose cotransporter 2 inhibitors have shown therapeutic benefits in HFrEF and HFpEF, but their effectiveness may vary across Asia. **Future Directions:** - Strengthening the prevention and standardized management of HF in Asia is crucial. - Controlling risk factors, promoting primary and secondary prevention, and optimizing hospital and outpatient care are essential for improving outcomes. This review highlights the need for more comprehensive data and region-specific strategies to address the high burden of HF in Asia.Heart failure (HF) is a complex clinical syndrome affecting multiple organs and systems, posing a significant public health concern due to its high prevalence, mortality, and medical costs. Asia, with its diverse population, ethnicities, and healthcare systems, faces unique challenges in HF prevention and management. This review aims to summarize the epidemiology, etiology, risk factors, outcomes, and management of HF in Asia, drawing from Global Burden of Disease (GBD) data and registry studies. **Epidemiology:** - The age-standardized prevalence of HF in Asia was 722.45 per 100,000 population, with China, Indonesia, and Malaysia having the highest rates. - The prevalence of HF varied across Asian regions, with East Asia having the highest rate (1,014.06 per 100,000 population) and South Asia the lowest (389.97 per 100,000 population). - The 1-year mortality rate for HF patients was highest in Indonesia (34.1%) and lowest in Korea (10.9%). **Causes and Risk Factors:** - Ischemic heart disease and hypertensive heart disease are the leading causes of HF in Asia. - Air pollution and ambient temperature variability are also significant risk factors. - Unhealthy lifestyle factors and cardiometabolic health metrics are associated with an increased risk of HF. **Outcomes:** - HF patients in Asia have high 1-year mortality rates, with cardiovascular (CV) deaths being the primary cause of death. - National-level registries in countries like Japan, Korea, and China show varying mortality and readmission rates, with CV deaths being the leading cause. **Management:** - Guideline-directed medical therapy (GDMT) is underutilized, with only a small proportion of patients receiving recommended doses of medications. - Device therapy, such as implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapies (CRTs), is also underutilized, with significant regional disparities. - Sodium-glucose cotransporter 2 inhibitors have shown therapeutic benefits in HFrEF and HFpEF, but their effectiveness may vary across Asia. **Future Directions:** - Strengthening the prevention and standardized management of HF in Asia is crucial. - Controlling risk factors, promoting primary and secondary prevention, and optimizing hospital and outpatient care are essential for improving outcomes. This review highlights the need for more comprehensive data and region-specific strategies to address the high burden of HF in Asia.