Iron deficiency anemia is widely present in patients with heart failure with an estimated prevalence of over 50% in ambulatory patients. It is an independent predictor of worse functional capacity and survival. Even without anemia,  iron deficiency is associated with poorer outcomes for these patients suggesting that the issue is not just relating to oxygen delivery but also broader energy generating metabolic parthways. At present, intravenous (IV) iron is the preferred route for treatment in heart failure patients. IV iron administration is associated with improvement in several important parameters. The latest research reveals important clinical action points for both GPs and specialists.