Parathyroid hormone-related peptide (PTHrP) is a member of a family of structural related peptides, including PTHrP, parathyroid hormone (PTH) and tuberoinfundibular peptide of 39 residues (TIP39). It is generally expressed throughout the cardiovascular system including endothelial cells, smooth muscle cells and atrial cardiomyocytes. Receptors for PTHrP are also expressed in several cell types of the cardiovascular system, including pacemaker cells, smooth muscle cells and atrial and ventricular cardiomyocytes. During the last decade the importance of this peptide hormone for the cardiac function has been recognized. Subsequently, mechanisms by which PTHrP can be released by different cell types have been identified. In addition, the current understanding of the interaction between endothelium-derived PTHrP for cardiac function has been improved by the recognition that PTHrP exerts specific effects on the heart which can not be mimicked by other members of this peptide family. This review will focus on the novel aspects of cardiac function of PTHrP and discuss the relevance of these observations under pathophysiological conditions, like heart failure. It will give an up-date of the current understanding of the interaction between PTHrP and heart function.