Due to its epidemiological characteristics, chronic heart failure refractory to conventional medical treatment is a significant problem involving an increasing number of cardiac patients. Chronic heart failure currently represents one of the most remarkable clinical manifestations of cardiovascular disease because of its frequency, morbidity, impact on quality of life, and costs. The use of new therapeutic approaches is particularly important for patients who become refractory to conventional therapies or are not eligible for heart transplant or other surgical treatment. The benefits of continuous extracorporeal ultrafiltration therapies are well known, but these treatments may be associated with complications and can be used only during hospitalization. Peritoneal ultrafiltration seems to be useful as chronic therapy to improve the quality of life and physical and social rehabilitation of patients with refractory chronic heart failure. The aim of this paper is to evaluate peritoneal ultrafiltration as an integrative treatment in chronic heart failure. Data from the literature suggest that peritoneal ultrafiltration is useful for the preservation of residual renal function, continuous ultrafiltration, hemodynamic stability, better middle-molecule clearance, sodium sieving with maintenance of normonatremia, and reduction of hospital admissions.