Cardiorenal syndrome (CRS) is a serious condition in which cardiac dysfunction leads to renal impairment and viceversa, with a high risk of mortality. This paper is a review of the most recent studies that investigated the role of Levosimendan on kidney function in case of patients with CRS. Compared with standard therapy (diuretics, other inotropes), Levosimendan has renoprotective effects associated with a lower mortality rate, it leads to an important improvement in NYHA class, a decrease in markers of congestion (BNP) and shortage of hospitalization stay. A study from 2018, in which Levosimendan was compared with Dobutamine, indicated that although both agents increase renal perfusion, only Levosimendan can improve GFR. In conclusion, Levosimendan – through its protective profile for both heart and kidneys, provides higher survival expectancy and seems to be the ideal alternative to the standard therapy in the management of hemodynamic CRS at present.