BACKGROUND: Anemia is regarded as one of poor prognostic factors of heart failure. Natriuretic peptide is also well established surrogate marker of heart failure. Association between anemia and natriuretic peptide is yet to be clarified. METHODS: One hundred forty eight patients diagnosed as heart failure and LVEF less than 45% were enrolled. Anemia was defined as hemoglobin level less than 13g/dl in men, and less than 12g/dL in women. We evaluated the association of hemoglobin level with NT pro-BNP and other clinical predictors. RESULTS: Of the 148 participants, 62(41.9%) had anemia. Hemoglobin level was inversely associated with log NT-proBNP (R 0.346, p<0.0001), age (R 0.291, p<0.0001), creatinine level (R 0.266, p<0.0001). Sex (p=0.02) and history of diabetes (p=0.005) were also correlated with hemoglobin level. After multiple logistic regression, log NT-proBNP (p<0.05) and creatinine level(p<0.001) remained as significant variable with hemoglobin level. CONCLUSIONS: Anemia is highly prevalent in heart failure. It can be postulated that anemia in heart failure is correlated with severity of heart failure and other clinical factors including renal function.