Heart failure (HF) is a leading cause of morbidity and mortality in industrialized countries and, increasingly, in developing countries. To achieve a major impact on outcomes such as survival and readmission rates for this disorder, it would be critical to identify “high-risk” patients for HF early enough to prevent or postpone the progression to overt HF. However, no simple screening test without the need for specialized techniques has yet been established for this condition. Circulating levels of cardiac B-type natriuretic peptide (BNP) is elevated in various forms of structural cardiac disease regardless of etiology and degree of ventricular systolic dysfunction, suggesting that plasma BNP testing could be a useful means for detecting both obvious and preclinical HF in a clinical setting. This review paper is intentionally focused on the recent status of plasma BNP measurement for identification of patients with left ventricular dysfunction, clinical congestive  HF, and  preclinical HF, especially in a mass screening  setting.