More than 5 million Americans are currently suffering from congestive heart failure (CHF). Congestive heart failure (CHF) is the number one cause of hospitalization in patients 65 years and older. A frequent issue seen amongst CHF patients is polypharmacy. Polypharmacy is defined as a patient taking 5 or more medications daily. Polypharmacy can lead to issues with adherence, and poor adherence can lead to poor patient outcomes and hospitalizations. This is where pharmacists play a crucial role, utilizing medication reconciliation and optimization. Performing medication reconciliation and optimization patients’ pill burden can be lightened which can lead to improved adherence and a decrease in adverse drug events and CHF related hospitalizations.