Takotsubo syndrome (TTS) or stress cardiomyopathy (SCMP) is a clinical condition characterized by a transient myocardial dysfunction that often affects postmenopausal women in response to a physical or emotional trigger. Despite being initially considered a benign clinical entity, it is well known that TTS can be associated with a non-negligible risk of in-hospital complications, including acute heart failure (HF), cardiogenic shock and ventricular arrhythmias. Non-invasive ventilation (NIV) has been widely used in patients with TTS complicated by pulmonary oedema and respiratory failure. However, in the absence of randomized clinical trials, the ventilation strategy for these patients is mainly based on a pathophysiological approach. This chapter aims to provide an overview of the application of NIV in patients with TTS and HF, focusing on the clinical scenarios of pulmonary oedema and respiratory failure in acute heart failure and cardiogenic shock.