Heart failure and lymphoedema are common conditions that often coexist, particularly in older people. Compression therapy, a cornerstone of lymphoedema care, is frequently withheld in those with heart failure due to safety concerns. This article explores the interaction between heart failure and lymphoedema, summarises current evidence on compression safety, and provides practical advice for community practitioners. It highlights key assessment tools (NYHA class, NT-proBNP, vascular tests), addresses common misconceptions, and signposts to national guidelines. With careful assessment and collaboration between cardiology and lymphoedema teams, compression therapy can be used safely in most patients, improving outcomes and quality of life.