Acute heart failure (AHF) involves the rapid or gradual onset of symptoms requiring unplanned hospital admission, with pulmonary edema as the primary manifestation of acute left heart failure. Acute cardiogenic pulmonary edema (ACPE) is characterized by severe pulmonary congestion causing type I respiratory failure. Non-invasive ventilation (NIV) is a pivotal strategy for managing ACPE in conscious, cooperative patients, avoiding endotracheal intubation while improving gas exchange and underlying hemodynamics. NIV modalities include continuous positive airway pressure (CPAP) and non-invasive pressure support ventilation (NIPSV). The benefits of NIV extend beyond respiratory improvements, with hemodynamic effects such as reduced left ventricular afterload and improved cardiac performance. As supported by clinical trials and meta-analyses, NIV also decreases intubation rates and hospital mortality. Despite its effectiveness, careful patient selection and monitoring are critical. Indications for NIV include respiratory distress (tachypnea, dyspnea), hypoxemia (SpO2 < 90%), and acidosis. Contraindications include cardiac arrest, severe hemodynamic instability, and unmanageable airway issues. NIV requires proper interfaces and settings tailored to individual needs, with CPAP commonly initiated at 5–10 cmH₂O and pressure support adjusted for effective tidal volume. Recent guidelines recommend early NIV in patients with respiratory distress to reduce the need for invasive ventilation. NIV, especially CPAP, is cost-effective and suitable for pre-hospital and hospital settings, while NIPSV may be reserved for more severe cases. Early application, sedation if necessary, and expert management of NIV are crucial for optimizing outcomes in acute heart failure.