OBJECTIVES: Limited evidence exists on the burden of chronic heart failure (CHF) in terms of reduced vs. preserved ejection fraction (HFrEF vs. HFpEF) and NYHA classification. This study aims to determine healthcare resource utilization associated with CHF, both for HFrEF (≥45%) and HFpEF (<40%) and according to NYHA class. METHODS: Retrospective analysis of a longitudinal population-based medical records database from southwestern Ontario was conducted. Records contain chart-abstracted information such as diagnosis, physician visits and consultation notes. Data of adult patients with CHF diagnosed between Jan 1^st, 2005 and Sept 31^st, 2012 with at least 1 year follow-up were included. Healthcare resources consumed by patients were identified in terms of hospitalizations, physician and emergency room visits and medical procedures. Data reported as mean values. RESULTS: Records of 8,983 patients were included: 39% with HFrEF, 49% with HFpEF and 12% with an ejection fraction between 40-45%. The median follow-up duration was 51.6 months. Most patients were in NYHA class II (30%) or class III (34%) followed by class I (22%) and class IV (14%). In comparison to the HFpEF cohort, total hospitalizations (3.0 vs. 4.2); including CHF hospitalizations (1.6 vs. 1.9), ER visits (2.1 vs. 3.1), GP visits (5.5 vs. 6.1), specialist visits (3.0 vs. 3.2), lab tests (5.8 vs. 7.7) and medical procedures (3.9 vs. 4.1) were numerically higher for the HFrEF cohort. Among patients in NYHA class II-IV (N=7006), hospitalizations (total: 4.5; CHF-related: 2.1) and lab tests (7.7) were numerically higher for class IV patients as was the frequency of GP visits (7.1) for class III patients. ER and specialist visits and medical procedures were similar across all NYHA classes. CONCLUSIONS: In a real-world Canadian setting, patients with HFrEF and those in NYHA class III-IV seem to experience greater resource use which is consistent with the existing literature.