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Background and Objective: Heart failure is the end stage of cardiac disease after that myocardium has used all its reserve and compensatory mechanism. This is a descriptive survey for determine underlying and precipitating etiology of congestive heart failure among patients who admitted on CCU and cardiac department of 5th Azar Hospital of Gorgan. Materials and Methods: In this study 145 patients aged between 19-87 years have participated by data collection using questionnaire and analysis by SPSS-10. Results: The results indicated. The most common underlying causes are myocardial ischemia (57.3%) and the most common precipitating factors is inappropriate drug therapy (75.8%). Orthopnea (86.2%) and ralls (82.8%) are the most symptoms and physical exam findings. AF rhythm with 24.1% is the most common arrhythmia and cardiothoracic ratio more than 0.5 is the most abnormal finding in CXR-PA. The average ejection fraction (EF) in male patients was 32.3% and in women it was 35.7%. There was meaningful relationship between male sex and EF (P<0.05). Conclusion: This study indicated that good control of HTN and preventing of (CAD) incidence are the most important factor to avoid from CHF and appropriating drug therapy has the essential role to maintain compensated state in heart failure.