Background/Introduction: Clinical outcome measures are the mainstay of cardiology trials. Congestive heart failure (CHF) measures have traditionally focused on average length of stay (LOS) and rehospitalisation and mortality rates. Purpose: We aimed to identify the significant factors of gender variability of CHF patients with a reduced ejection fraction (HFrEF). Methods: We performed gender comparison of statistically relevant variables using prospectively collected data of HFrEF patients hospitalised over a 12month period. Results: Of 174 consecutive patients, 135 (78%) were males and 39 (22%) were females. Compared to males, females had a statistically significant older age (64 vs. 58; P < 0.001), higher ejection fraction (EF) (28% vs. 23%; P = 0.023) and no history of active smoking (0% vs. 16%; P = 0.005) and less use of beta blockers (76% vs. 93%; P = 0.006), digitalis (2% vs. 12%; P = 0.009) and mineralocorticoid receptor antagonist drugs (35% vs. 55%; P = 0.025). After one year, both males and females had similar allcause and heart failure hospitalisation and rehospitalisation rates. Females showed no differences in inhouse mortality, combined inhouse mortality/30day rehospitalisation rates and composite myocardial infarction/stroke rates, compared to males. Males were more likely to require defibrillator device implantation (34% vs. 12%; P = 0.008) Conclusion: Our findings showed that female HFrEF patients had similar LOS; inhouse mortality, hospitalisation and rehospitalisation rates; less utilisation for implantable devices.