An important hallmark of cardiac failure is abnormal second messenger signaling due to impaired synthesis and catabolism of adenosine 3’,5’-cyclic monophosphate (cAMP) and cyclic guanosine 3’,5’-cyclic monophosphate (cGMP). Their dysregulation, altered intracellular targeting, and blunted responsiveness to stimulating pathways all contribute to pathological remodeling, muscle dysfunction, reduced cell survival and metabolism, and other abnormalities. Therapeutic enhancement of either cyclic nucleotide can be achieved by stimulating their synthesis and/or by suppressing members of the family of cyclic nucleotide phosphodiesterases (PDEs). The heart expresses seven of the eleven major PDE sub-types - PDE1, 2, 3, 4, 5, 8, and 9. Their differential control over cAMP and cGMP signaling in various cell types, including cardiomyocytes, provides intriguing therapeutic opportunities to counter heart disease. This review examines the roles of these PDEs in the failing and hypertrophied heart, and summarizes experimental and clinical data that has explored the utility of targeted PDE inhibition.