Heart failure (HF) is a growing healthcare concern in the civilized countries, with at least 26 million people worldwide affected by the disease. Features of HF are impairment in both maximal and submaximal exercise capacity. Several comorbidities may exacerbate the basal condition of pump dysfunction. One of them, probably the most frequent, is the presence of chronic obstructive pulmonary disease (COPD). COPD is estimated to be present between 20% and 40% in the HF population. When associated with HF, the physiopathological consequences of pulmonary obstruction and/or lung hyperinflation have detrimental effects on the cardiovascular system. Cardiac end-diastolic and end-systolic stroke volumes and right ventricular function may be compromised. Patients with HF and COPD exhibit distinct clinical and therapeutic management characteristics both in the emergency department and in the intensive care unit requiring more frequent hospitalization. The most common reasons for emergency department admission for acute respiratory failure are exacerbations of chronic diseases above all when a decompensated underlying heart failure is present. Noninvasive respiratory support strategies are increasingly used in the last decades.