Introduction: Heart failure results from complex mechanisms initial stressors leads to myocardial damage. With neuro-endocrine activation and cytokine release. Inadequate compensation leads to heart failure.

Aims: To determine aetiologic factors for heart failure in a teaching hospital in southern, Nigeria

Methodology: One hundred and eighty six patients were diagnosed using framinham criteria for heart failure. Investigations like chest X-ray and echocardiography was done.

Results: Hypertension was the most common risk factor with 138 (74.2%) respondents. On echocardiography, 162 (64.5%) had hypertensive heart disease, 34 (18.3%) had valvular heart disease

Conclusion: Hypertension is the most common risk factor and hypertensive heart disease is the most common aetiology for heart failure

Keyword: Hypertension, Echocardiography, Hypertensive heart disease.