Abstract: Heart failure (HF) has become a major challenge in global public health, and its incidence and lethality are on the rise. While the effectiveness of clinical interventions in modern medicine, they are accompanied by rising adverse drug reactions, recurring diseases, and no reduction in long-term mortality. In this context, herb pairing methods informed by traditional Chinese medicine theories, through mechanisms of multi-component synergy and multi-target network regulation, have been vital in HF prevention and treatment. In this study, we have gathered and analyzed recent investigations on the pharmacological effects of traditional Chinese medicine for HF, resulting in a list of 16 notable and representative herb pairs. Their main functions include reducing inflammation, countering oxidative stress, preventing apoptosis, inhibiting cardiac fibrosis, regulating neuroendocrine disorders and myocardial microcirculation, and ultimately preventing or treating HF, thus broadening the scope of personalized clinical drug regimens and the development of new therapeutic agents.