In this review work are presented the latest findings of the use of levosimendan, a newer inodilation drug that by its action does not increase the consumption of oxygen in the heart muscle and does not worsen the myocardial ischemia. Its use is recommended to all patients with de novo acute heart failure (HF) and acute exacerbation of the chronic HF followed by hypotension and systemic hypoperfusion. It is repeatedly given to patients with advanced chronic HF in order to relieve cognitive and hypoperfusion symptoms and also result with less frequent hospital treatment. To cardiac surgery patients, it is applied to those with advanced ischemic heart disease and a reduced heart ejection fraction (EF ≤ 40%) and for the prevention and treatment of low heart output syndrome. In cardiogenic shock, it improves heart function and reduces the need for catecholamines. In patients with acute coronary syndrome due to its inotropic and cardioprotective action, it limits the loss of myocytes and improves heart function. In cardio-renal syndrome, it reduces kidney congestion and improve blood flow through the kidneys and increase glomerular filtration. Levosimendan is also used in right HF, especially when associated with pulmonary hypertension. The hemodynamic effects of levosimendan, increased heart contractility and vasodilatation are dose-dependent. Due to the action of the active metabolites, it has an prolong effect of 7-10 days after 24 infusion. Its beneficial effect on the heart is expressed also to the patients on chronic therapy with beta blockers. Due to its haemodynamic properties and safety profile, levosimendan should recently considered more often as a alternative to traditional inotropes. Unlike to all available inotropic drugs, its clinical application is least likely to worsen prognosis characteristically for adrenergic inotropic drugs.