Objective To understand the epidemic characteristics of heart failure in Guangzhou, and to provide a basis for the prevention and control of heart failure. Methods The information of patients hospitalized for heart failure in Guangzhou from January 1, 2017 to December 31, 2021 was collected, and t test, rank sum test, and χ² test were used to analyze the differences of central tendency and composition ratio. Results From 2017 to 2021, there were 6 823 hospitalized patients with heart failure in Guangzhou, with 8,716 hospitalizations and 849 deaths. The average age of hospitalization was 78.50 ±10.48 years old. Male patients were younger than female patients (P<0.001), and females died 3.86 years later than males on average (P<0.001). The number of hospitalizations for males (4 251 person times, accounting for 48.77%) was less than that for females (4 465 person times, accounting for 51.23%), and the number of hospitalizations for urban registered residence (7 346 person times, accounting for 84.28%) was much more than that for rural registered residence (1 370 person times, accounting for 15.72%). The number of hospitalizations in the fourth quarter was the largest. The combined rates of coronary heart disease, hypertension, type 2 diabetes, chronic obstructive pulmonary disease and hyperlipidemia were 58.65%, 69.52%, 34.92%, 10.69% and 10.23% respectively. There were differences in age, registered residence, residential area and complications among patients with acute and chronic heart failure (P<0.05). Conclusion The mortality of patients with heart failure in Guangzhou is high, and the distribution characteristics of acute and chronic heart failure is different. Corresponding preventive measures should be taken for different groups to reduce the disease burden and improve the quality of life.