This chapter reviews the use of a multi-factorial cardiac rehabilitation approach for patients with established heart failure (HF). Cardiac rehabilitation is the ideal comprehensive structured disease intervention since it best addresses the complex interplay of medical, psychological, and behavioural factors facing patients with HF. It is a coordinated multi-dimensional intervention designed to stabilise or slow disease progression, alleviate symptoms, improve exercise tolerance, and enhance quality of life, thereby reducing morbidity and mortality. In populations of patients with HF, such a programme has been proven to improve functional capacity, recovery, and emotional well-being and reduce hospital admission. Exercise training as a key component in a cardiac rehabilitation programme may improve survival and reduce hospitalisation in stable HF patients. However, despite the virtues of cardiac rehabilitation, only a small percentage of eligible HF patients ever get referred, due to barriers such as lack of physician and patient-family awareness of its benefits and logistical or financial constraints.