Sotagliflozin is the first dual sodium-glucose cotransporter 1 and 2 (SGLT1/2) inhibitor. It inhibits renal transporters (SGLT2) and intestinal transporters (SGLT1) of glucose. It improves blood sugar control, reduces cardiovascular risk, blood pressure and regulates body weight. Recent randomized trials have shown that it significantly reduces the risk of major cardiovascular events, heart failure hospitalizations, and all-cause death in patients with and without diabetes. The safety profile is generally favorable, but requires monitoring for gastrointestinal effects and diabetic ketoacidosis. The article synthesizes mechanisms of action, clinical evidence, and practical considerations for integration into the treatment of heart failure. Sotagliflozin represents an innovation in cardiometabolic therapy.