Heart failure is a complex and a debilitating syndrome (Driscoll, Worrall-Carte, Hare, Davidson, Riegel, Tonkin & Stewart, 2011) requiring complex management that places a significant burden on an individual, community and the health care system (McDonagh, 2005). However, cardiac patients in the third world including Pakistan, often suffer not only from the nature of their illness but also from the insufficiency of facilities available to treat them and to enhance their functional capabilities at work, home and in community than patients in more developed countries (Utriyaprasit & Moore, 2005). Therefore, concerted efforts are needed to manage heart failure patients in developing countries. Objective: This paper aims at elaborating the role of a nurse led case management program for heart failure patients in the light of literature within the context of Pakistan. Nurse led case management: Nursing case management is a dynamic and systematic collaborative approach to provide and coordinate health care services to a defined population (American Nurse Credentialing Centre). The nurse case manager is the coordinator of a multidisciplinary treatment plan which addresses a patient/ family’s continuum of care needs while ensuring clinical quality that is cost and time effective (White & Hall, 2006). As the complex nature of the disease requires holistic management, this approach provides patients with home visits, telephone calls, counseling sessions, support group and skills building. Conclusion: Nurse led case management should be introduced for the care of heart failure patients in Pakistan to improve quality and continuity of care, reducing length of hospital stay, improving pt satisfaction and assisting with the reduction in overall health care costs.