OBJECTIVES: Heart failure (HF) patients are frequently hospitalized, resulting in reduced quality of life and increased health expenditures. This study estimates recent rates of hospitalizations among systolic HF patients in the US. METHODS: This retrospective study used a large, nationally representative commercial database. Adult patients aged 18-64 years with ≥1 inpatient or ≥2 outpatient diagnoses of systolic HF (ICD-9-CM 428.2x, 428.4x) in 2008-2013 with  ≥12-months of claims data prior to and ≥ 1-month claims data after the first systolic HF diagnosis were included. Number of hospitalizations per patient-year of all-cause hospitalizations and hospitalizations with HF as a discharge diagnosis during the entire follow up were summarized. Hospitalization rates after patients had 1, 2, and 3 all-cause hospitalizations were also reported. RESULTS: A total of 25,830 patients (mean age=54 (SD 8.6); 63% male; 34% hypertension; 26% diabetes; 21% dyslipidemia; 20% arrhythmias) met the study criteria, with a mean follow up of 19 (SD 14.7) months. 67.8% of patients were hospitalized during the follow up, 29.3% had 2+, 16.1% had 3+ hospitalizations. During the entire study period following the systolic HF diagnosis, the mean numbers of hospitalizations per patient-year were 1.63 (SD=2.62) for all-cause and 1.22 (SD=2.16) for HF hospitalizations.  After the first all-cause hospitalization, the mean number of subsequent hospitalizations per patient-year was 1.02 (SD=2.17) for all-cause and 0.50 (SD=1.45) for HF hospitalizations. The annualized rates for subsequent hospitalizations were higher after the 2^nd and 3^rd all-cause hospitalizations. CONCLUSIONS: From the time of diagnosis with systolic HF, hospitalizations are common and some patients experience multiple hospitalizations per year. The risk of subsequent hospitalizations increased in subjects with a history of recurrent hospitalizations. Interventions targeted at preventing HF hospitalizations would be beneficial.