Digoxin and related substances were the first drugs used for the treatment of heart failure. Their use, however, has significantly decreased in the past few years, because of their neutral effect on mortality and because of proven efficacy of drugs acting on neurohumoral activation. In our paper, after presenting the farmacology of the drug, we summarize the most important arguments which favour the actuality of digoxin treatment, review practical issues of therapy and the present digoxin use in our clinic.