Abstract Background and Objectives: Identify the factors affecting quality of life (QOL) is one of the major goals for improving the Health Related Quality Of Life (HR-QOL) in patients suffering from Congestive Heart Failure (CHF). Considering the fact that there are few published studies in this regard in Iran, as a developing country, this research was designed to determine the HR-QOL in Iranian CHF patients and its related factors. Methods and Materials: In this cross-sectional study, random sampling was used to select 1840 female CHF patients. After obtaining informed consent, patients' demographic and disease-related data (using a researcher-made questionnaire which assessed eight dimensions including role-physical, physical functioning, bodily pain, general health, vitality, role-emotional, social functioning and mental health), and the HR-QOL data (using the SF-36 questionnaire) were assessed and analyzed with SPSS version 15. Results: A high proportion of the participants had an unfavorable HR-QOL in physical functioning (44.56%), role-physical (49.55%), role-emotional (59.83%), mental health (54.50%), and general health (53.36%) dimensions and a relatively favorable HR-QOL in social functioning (50.57%), vitality (49.26%), and body pain dimensions (52.55%). A significant relationship was found between the HR-QOL and the employment status, level of education, being cared for at home, functional capacity, disease duration, frequency of medical encounter and hospitalization, duration of hypertension and concurrent CHF, presence of edema, presence of disease symptoms and morbidities, intensity of fatigue at the study time and previous months, and the type of medications. Conclusion: According to the results, QOL in CHF patients was unfavorable in the scales of general health, role-emotional, and mental health.