Background: Acute heart failure (AHF) is a life-threatening medical condition requiring urgent evaluation and treatment, this study aimed to evaluate efficacy and safety of the early use of Ivabradine alone versus Beta blockers when tolerated in patients with acute heart failure. Methods: The study included two groups of patients; Group 1: It included 30 patients prescribed beta-blockers, and Group 2: It included 30 patients prescribed Ivabradine, All patients were subjected to full history taking, complete clinical examination, 12 lead surface ECG, full echocardiography study, Follow up of Patients after one month: by Exercise Tolerance Assessed by 6 Minute Walking Test (6MWD), Quality of life, Heart rate, and NYHA class. Results: Group (1) included 24 (80%) males & 6 (20%) females, their median age was 60.0 years, Group (2) included 23 (76.7%) males & 7 (23.3%) females, their Median age was 59.5 years, There was no statistical significant difference between two groups regarding NYHA class before and after intervention(P>0.05 for both), 6MWD before and after 1 month. HR before and after the walk test either at baseline or after 1m of treatment (P>0.5 for all), dyspnea before and after the walk test either at baseline or after 1m of treatment (P>0.5 for all), or fatigue before and after the walk test either at baseline or after 1 month of treatment (P>0.5 for all). Conclusion: Both groups achieved comparable reduction in HR with improvement in functional capacity and exercise tolerance which can be translated to better prognosis.