Home-based inotropic therapy represents a therapeutic strategy in patients with advanced heart failure (AdvHF), both for a bridge to life-saving treatments such as heart transplant or ventricular assist devices and for palliative care in patients not eligible for these therapeutic options. In this review, we explore the role of home-administered inotropes, specifically dobutamine, milrinone, dopamine, and levosimendan, in the management of AdvHF patients through a summary of current literature and the presentation of management models adopted in selected Italian centers. Reported experiences suggest improved quality of life, reduced hospital admissions, and enhanced clinical stability in patients with AdvHF. These models may serve as practical examples for organizing care pathways in a clinical context that remains poorly defined by current guidelines.