We preliminarily assessed the utility of a steam foot bath in 4 male patients with dilated cardiomyopathy with refractory chronic congestive heart failure awaiting heart transplantation. Sublingual temperature significantly increased from 36.1 +/- 0.3 to 36.7 +/- 0.2 degrees C (p = 0.01). Blood pressure, heart rate and numbers of ventricular arrhythmia did not differ before and after two weeks of the therapy. Grade of mitral regurgitation tended to decrease (2.0 +/- 1.2 to 1.3 +/- 1.0, p = 0.06), and endothelial function measured by arterial tonometry significantly increased from 1.35 +/- 0.26 to 2.13 +/- 0.26 (p = 0.02). Thus, steam foot bath therapy may be safe and beneficial for the patients with endstage heart failure awaiting heart transplantation.