OBJECTIVES: Iron deficiency (ID) is highly prevalent in chronic heart failure (CHF) patients and imposes a significant disease burden for CHF patients with enormous impact on their outcome. Thus, this study was designed to identify epidemiological data, screening and treatment guidelines, costs as well as outcome of intravenous iron treatment in patients with CHF and iron deficiency. METHODS: A comprehensive literature review was undertaken for all publications from 1998 to September 2014 using Medline, EMBASE, Cochrane, Science Direct and Pubmed databases, comprising English and German articles. The review focused on studies based on patients with chronic heart failure and iron deficiency, with or without anemia. Articles were systematically selected if they included data for iron deficiency on at least one of the following criteria: epidemiology, screening and treatment guidelines, costs, clinical outcomes. RESULTS: Database search yielded 5,132 articles and 55 additional articles were identified via secondary hand searches. Of the 73 eligible articles; 30 provided information on epidemiological data, 14 on screening and treatment guidelines, 15 on costs and 14 on clinical outcomes. The prevalence of CHF ranges between 0.88-6.4%. Out of these, 8-53% suffer from iron deficiency depending on the disease severity (New York Heart Association classes - NYHA) of heart failure. According to the ESC Guidelines 2012 intravenous iron may be considered to improve symptoms, quality of life and exercise capacity based on the data of FCM (FAIR-HF, CONFIRM-HF–based on 456 patients). Considering the included studies of this review, healthcare expenditure on CHF consumes 1-2% of the total healthcare budget. CHF patients with ID induce higher healthcare costs compared to non-iron deficient patients (+24%).  CONCLUSIONS: CHF represents a major and growing public health problem and is often associated with ID as co-morbidity. IV iron can be an option to improve outcome (patient status), and reduce health care costs.