Perinatal heart failure refers to the occurrence of heart failure between 28 weeks of gestation and one week postpartum. Its cause could be divided into two categories: with pre-existing or pregnancy-related cardiovascular diseases， including congenital heart disease， rheumatic heart disease， or gestational hypertension （preeclampsia， especially）， peripartum cardiomyopathy， etc. Careful differential diagnosis is required. Treatment of heart failure in pregnant women should always involve a multidisciplinary team approach， targeting at the specific etiology and considering both mother and baby. Prenatal heart failure is a great challenge in our times， demanding more comprehensive studies.