Introduction: Although effective treatments have reduced the number of deaths attributable to heart failure, there is a growing burden of sub-optimal disease management. Studies have shown that only ~50% of heart failure patients demonstrate treatment non-adherence. Although several known social determinants of health (SDOH) impact incidence and prevalence of heart failure, the intersection between treatment adherence and SDOH and its effect on heart failure patients remains understudied. Methods: This narrative literature review aims to identify the effects of SDOH on treatment adherence in heart failure patients. Keywords and MeSH terms were selected to encapsulate SDOH, heart failure, and treatment adherence. Using those terms, a literature search of all studies published from 2006 through 2022 in English or with an available translation was completed using PubMed, CINAHL, and Web of Science. Of the 61 articles identified we removed 9 duplicates, resulting in 51 original articles. Following title and abstract review, 36 articles were selected for full review, following which 8 were included in the final literature review. Results: Seven studies were conducted within the United States, one in Italy, and one in Central and South America. The outcome, treatment adherence, was defined as medication adherence (63% of studies, 5 of 8), self-care index (13%, 1 of 8), participation in cardiac rehabilitation (13%, 1 of 8), and lifestyle changes (13%, 1 of 8). Of the studies reviewed, the most frequently examined SDOH were sex (88%, 7 of 8), income (75%, 6 of 8), and education (50%, 4 of 8). Fewer studies included race/ethnicity (38%, 3 of 8), region (25%, 2 of 8), or social support (13%, 1 of 8). Income, social support, and education were correlated with low treatment adherence. High rates of cardiovascular hospitalizations were observed in those with low adherence. Results surrounding sex were mixed; one study showed female sex as protective on treatment adherence while a second study suggested an adverse effect. No studies examined the association between rurality or access to healthcare with treatment adherence in heart failure. Conclusion: Several SDOH impact treatment adherence in heart failure patients. However, studies examining the impact of SDOH outside of sex, income, ethnicity, and studies examining components of heart failure treatment, outside of medication adherence, are lacking. This narrative review highlights the paucity of literature investigating facets of treatment other than medication adherence. Additionally, future research should include more robust and informative measures of SDOH to inform strategies for the management of heart failure.