Aim – To study the etiology and clinical profile of patients with Heart failure and preserved ejection fraction. Methods – Patients admitted to the PMCH central emergency and the OPD with heart failure were included in the study. After proper evaluation and data collection the patient of Heart Failure with preserved ejection fraction were taken as case and those with decreased ejection fraction formed the control wing.The data collected were tabulated and statistically analysed. Results – HFPEF accounts for 40% of all heart failures. HFPEF is more common in elderly population(mean age 70 yrs). Important risk factors for HFPEF are female gender(60%), hypertension(78%), diabetes mellitus(45%), obesity(60 %), dyslipidemia(30%) and renal dysfunction(25%). Ischemic heart disease(40%) and hypertension are the common causes of HFNEF. The electrocardiographic profile consisted of atrial arrhythmias(60 %), LVH(30%), bundle branch blocks, etc. Chest radiography revealed cardiomegaly(30%), pulmonary venous hypertension, pulmonary plethora, pulmonary edema(2%). Echocardiographic profile included preserved ejection fraction(mean 55%), diastolic dysfunction, left ventricular hypertrophy, reduced mitral inflow, increased LA volume. Summary and conclusion – HFPEF contributes to 40% of all heart failures.HFPEF is more common in elderly population. Important risk factors for HFPEF are hypertension, diabetes mellitus, obesity, dyslipidemia and renal dysfunction.