<p>Heart failure (HF) is a clinical syndrome with a wide range of presentations due to functional and structural abnormalities of the heart. HF may induce the development of cognitive impairment and increased risk of dementia. HF frequently coexists with cognitive impairments in about 40–60% of elderly patients. In addition, cognitive impairment reduces life quality and increases mortality in patients with HF, signifying a close interrelated relationship between HF and cognitive impairment. Prominently, regional brain hypoperfusion in patients with HF leads to autonomic dysfunction, mood, and cognitive disorders. HF increases the risk of vascular dementia (VD), which refers to cardiogenic dementia. Remarkably, the anti-failure drug digoxin, which is commonly used in the management of HF, affects the development of cognitive impairment and dementia. Numerous studies highlighted the neuroprotective effect of digoxin against the development of cognitive impairment and dementia. Though, the fundamental neuroprotective mechanisms of digoxin against cognitive impairment and dementia are not completely explained. This review seeks to examine the relationship between heart failure and the onset of cognitive impairment and dementia, as well as the role of digoxin in mitigating the adverse impact of heart failure on cognitive function.</p>