Summary: Inotropic agents are an important group of drugs in the treatment of heart failure (HF). These agents include digoxin, dobutamine, dopamine, norepinephrine, milrinone, levosimendan, and omecamtiv mekabril. Acting through a variety of mechanisms, they increase myocardial contractility, which is a direct therapeutic response to the reduced cardiac output in HF. However, clinical studies conducted so far have shown that classical inotropic agents do not have a positive impact on the life expectancy of patients with HF, sometimes having the opposite effect. However, the emerging new substances with different mechanisms of action give hope for better long-term effects. The aim of this article is to summarize the role of inotropic drugs in the modern HF therapy in the context of benefits and risks resulting from their administration.