Heart failure (HF) is still a significant public health concern. Every year, an estimated 500,000 Americans are diagnosed with HF. Despite improved medical and surgical therapies for heart failure, death rates after the start of the disease remain high, emphasizing the need of primary prevention. Alcohol intake seems to have a role in the development of HF among modifiable lifestyle variables. Although excessive drinking has been linked to alcoholic cardiomyopathy and light-to-moderate drinking has been shown to have some cardiovascular benefits, new research suggests that not only the quantity of alcohol consumed, but also drinking patterns and genetic factors, may influence the link between alcohol consumption and cardiovascular disease. The existing evidence on the link between alcohol intake and HF is reviewed in this article.