Acute cardiogenic pulmonary edema is a frequent life-threatening emergency. During the last 10 years, increasing attention has focused on the use of noninvasive ventilation to treat patients with various forms of acute respiratory failure. Numerous physiologic data and clinical studies support the use of noninvasive ventilation during cardiogenic pulmonary edema. Noninvasive ventilation results in rapid improvement of clinical signs of respiratory distress and gas exchange and decreases the need for endotracheal intubation for patients in the ICU with acute hypercapnic respiratory failure related to cardiogenic pulmonary edema. However, no sustained benefit (ie, decreased late mortality) or benefit for less severe forms of cardiogenic pulmonary edema has been demonstrated yet. Moreover, there are still few data that support the use of a specific mode of ventilation over the others.