Coronary artery disease is the main cause of congestive heart failure (CHF) in all populations. Latin American countries (LAC) are undergoing the first phase of an epidemic of coronary artery disease that probably will lead to an increased incidence of CHF. The progressive implementation of successful interventions, such as early reperfusion and rehabilitation programs, should increase the survival of patients with acute myocardial infarction and the population at high risk of CHF. The increasing prevalence of risk factors, such as diabetes, hypertension, and obesity, and the ageing of the population may also contribute to a rising incidence of CHF in LAC. Moreover, infectious diseases such as Chagas disease and rheumatic heart disease, known causes of CHF, are still frequent in this population and additionally contribute to the incidence of CHF. If timely preventive interventions are not implemented, CHF could become one of the main contributors to the burden of morbidity, mortality, and health costs in LAC. Properly conducted clinical and epidemiologic studies are needed to identify, implement, and evaluate preventive strategies that are likely to succeed within the specific context of LAC.