Abstract Background: Iron deficiency anemia is widely present in patients with heart failure (HF) with an estimated prevalence of over 50% in ambulatory patients. It is an independent predictor of worse functional capacity and survival. Aim of Study: To measure serum hepicidin in patients with chronic systolic HF, compare this with healthy subjects and correlate iron status (serum ferritin and transferrin satu-ration) and serum hepicidin and the stages of HF severity. Patients and Methods: Sixty patients with systolic HF diagnosed at the outpatient clinic or Cardiology Department at the Mansoura Specialized Internal Medicine Hospital, Mansoura University, Mansoura, Egypt, were included in the study. Results: The mean age of the patients was 62.33±7.48 years, and in the control group was 61.13±7.50 years. In the cases group, there was 83.3% males and 16.7% females versus 63.3% males and 36.7% females in the control group. Forty five cases (75%) presented with class II NYHA classification HF and 15 cases (25%) with class III NYHA classification heart failure. The median levels of hemoglobin concentration, mean corpuscular volume, serum iron, serum ferritin and hepcidin level were higher in NYHA class II cases as compared to class III. The best cutoff point of hepcidin to identify HF cases from the control was below 9.15ng/ml with 63.3% sensitivity and 89.3% specificity. The AUC was 0.772 with high statistically difference (p<0.001). Conclusion: Heart failure is associated with anemia, especially iron deficiency anemia, Serum hepcidin could be utilized as a marker for heart failure as it is increased with the disease severity.