Cancer and heart failure rank among the leading causes of morbidity and mortality worldwide, posing significant public health challenges. Advances in cancer treatment, particularly for early-detected cases, have markedly improved survival rates. Over the past few decades, 5-year survival rates for many cancers have increased by nearly 10%. However, cancer therapies—alongside the disease itself—often result in cardiotoxicity, a critical complication that can lead to cardiac dysfunction and heart failure. The relationship between cancer and heart failure is multifaceted and interdependent, creating a vicious cycle where each condition worsens the progression and treatment outcomes of the other. The effects are cumulative, progressive and dose-dependent, with damage occurring during or years after therapy. Recognizing and managing cardiac dysfunction early is essential to preserve the survival benefits achieved with cancer care. Advances in heart failure treatments, coupled with the development of specialized cardio-oncology centres, have greatly improved the ability to address this complex interaction. This chapter summarizes the cardiac dysfunction and heart failure elicited by novel cancer therapeutics, emphasizing in the end the current management strategies aimed at optimizing patients’ outcomes.