Background: Anemia is associated with increased morbidity and mortality in heart failure and is often due to abnormal iron metabolism. The aim of this study is to examine the relation between iron status and patients with chronic heart failure (reduced vs. preserved systolic function ), etiology, age, gender, functional class and cachexia. Methods: We examined 50 patients mean age 55±14 years, 78% male. Full history taking and complete clinical examination as well as ECG, echocardiographic and laboratory data {hemoglobin(Hb), serum iron, transferrin saturation, total iron binding capacity(TIBC), serum ferritin and serum transfrrin} were collected. Anemia was defined as Hb less than 13 g/dl in males and 12 g/dl in females (WHO criteria) and iron deficiency was defined by presence of low serum iron, high TIBC and low transferrin saturation. Results: 62% of patients were anemic, 60% in class (III and IV) dyspnea, 74% reduced LVEF(EF<50%) and 64% had iron deficiency. Iron deficiency was more prevalent in females, functional class III and IV, patients with low EF and old patients(>65 years). The prevalence of iron deficiency in anemic group and non anemic group were 77% and 47% respectively (p =0.108). Conclusions: Iron metabolism appears to be impaired in CHF patients, irrespective of presence of anemia. The higher incidence of iron deficiency among patients with more deteriorated heart function is consistent with the view that iron deficiency is a marker of a more severe disease. Thus determination of the iron status in all CHF patients could justify those at risk of developing iron deficiency anemia and more severe disease.