Adherence to prescribed treatments is an essential prerequisite for a therapy to be effective. In cardiology, poor therapeutic adherence is a problem that affects 50% of patients in primary prevention and 44% in secondary prevention, with a consequent significant impact on prognosis and global health costs. In this review, we analyze the possible causes of poor adherence and discuss possible interventions to be implemented to address this problem. In detail, we briefly report the evidence supporting deprescribing, the use of the polypill, the innovative treatments with gene silencing, and digital technologies as potential approaches to improve adherence in the cardiovascular field.