Background: There is growing evidence that anemia is common in CHF patients and possibly related to symptoms and prognosis. But, there is considerable disagreement about the prevalence of anemia in CHF patients. Methods: In 128 consecutive patients(60 male, 69.112.7 yrs) admitted with CHF due to left ventricular systolic dysfunction (LV ejection fraction less than 40%), demographic features and serum hemoglobin(Hgb), creatinine, echocardiographic findings were evaluated. Anemia was considered to be present when the Hgb on admission <12g/dL. Results: Fifty eight (45.3%) of the 128 patients were considered as anemic and 25 (19.5%) showed Hgb level less than 10g/dL on admission. Anemia was more frequent in female than male (67.2% vs 32.8%, p<0.01). Forty five (77.6%) out of 58 anemic patients showed normocytic normochrmic anemia, 6 were macrocytic. Microcytic anemia suggestive of iron deficiency state was revealed in 7 (12.1%) cases. Serum Hgb level was significantly lower in CHF patients with NYHA class 4 (10.96.1) than class 2 and 3 (12.62.7, 12.46.0g/dL respectively, p<0.01). LVEF was not significantly different with functional class. Serum Hgb level was reduced as serum creatinine level increase(r=0.288, p<0.001). But, Hgb level was not significantly lower than those without renal insufficiency (serum Cr >1.5mg/dL) (12.15.7 vs 11.35.7g/dL). Conclusion: Anemia is a common finding in hospitalized patients with CHF and associated with severity of symptom. Mainly normocytic normochromic anemia is found among the patients with anemia and suggested that pathogenesis other than iron deficiency is the main mechanism of anemia in patients with CHF.