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Milrinone is a medication indicated for cardiac support in patients with acute heart failure, pulmonary hypertension, or chronic heart failure. It is often used during cardiac surgeries, including coronary artery bypass graft surgery, cardiac transplantation, and other cardiac surgeries requiring cardiac support. It functions by improving cardiac contractility (inotropy), cardiac relaxation (lusitropy), and inducing vasodilation and has the overall effect of increased cardiac output, improvement of left ventricle-arterial coupling, and enhanced cardiac mechanical efficiency. Its use is primarily in the perioperative and ICU settings, although it also has utility for outpatient therapy in select patient populations. This activity will review its mechanism of action, indications, and potential harm and benefits associated with its use. It will also discuss its role throughout various specialties of medicine, including ICU care, perioperative care, use in pediatric populations, and the now discontinued use in the outpatient setting as an oral medication.