This review study explores the therapeutic potential of External Extracorporeal Counterpulsation (EECP) in the context of Heart Failure with Preserved Ejection Fraction (HFpEF). Drawing from various studies, the analysis delves into the mechanisms of action underlying EECP, emphasizing its impact on exercise capacity, symptomatic relief, and different cardiovascular parameters. The research suggests that EECP, with its multifaceted effects on endothelial function, oxidative stress reduction, and promotion of angiogenesis, holds promise as a tailored intervention for HFpEF. Despite promising outcomes, the review acknowledges limitations, such as the need for standardized protocols and further large-scale trials. Looking ahead, the future direction of research is envisioned to refine patient selection criteria, optimize treatment regimens, and assess the long-term implications of EECP in HFpEF management. This abstract encapsulates the evolving landscape of cardiovascular therapeutics, positioning EECP as a noteworthy modality deserving continued exploration for its efficacy, safety, and potential integration into the holistic care of HFpEF patients.