Cardiac tumors are considered rare clinical entities and can affect any cardiac tissue. Metastatic (secondary) cardiac tumors are more frequently diagnosed than primary tumors (malignant or benign). Both types can cause valve and/or inflow and outflow tract obstructions in any cardiac chamber, leading to symptoms of heart failure, as well as embolization and arrhythmia. Treatment of benign tumors is usually surgical, and that of metastatic and primary malignant tumors will depend on their origin and type, with poor prognosis. Recurrence of benign tumors is frequent. The aim of this article is to provide the clinician with tools to optimize diagnosis, differential diagnosis, and treatment of tumors with obstructive features causing heart failure.