Objective To observe the changes of serum heart-type fatty acid-binding protein (h-FABP) and brain natriuretic peptide (BNP) for assessing the clinical values in children with chronic heart failure (CHF). Methods A total of 50 patients with CHF, including 22 endocardial fibroelastosis (EFE) cases and 28 dilated cardiomyopathy (DCM) cases, were enrolled. Thirty healthy children were enrolled as controls. The concentrations of serum h-FABP and BNP were measured by enzyme-linked immunosorbent assay (ELISA), and the left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), and cardiac index (CI) were measured by echocardiography. Results The concentrations of serum h-FABP and BNP in patients with CHF were significantly higher than those in control group (22.68±4.18 ng/mL vs. 6.31 ± 1.72 ng/mL; 565.52±179.64 pg/mL vs.31.22±9.83 pg/mL, all, P 0.05). The h-FABP concentration in CHF patients was positively correlated with BNP ((r=0.782, P<0.01). The h-FABP concentration in CHF patients was positively correlated with LVESD, LVEDD (r = 0.626, 0.662, respectively; all, P<0.01), and negatively correlated with LVEF, LVFS, and CI (r = -0.652, -0.636, -0.709, respectively; all, P<0.01). The BNP concentration was also positively correlated with LVESD, LVEDD (r = 0.733, 0.689, respectively; all, P<0.01), and negatively correlated with LVEF, LVFS, and CI (r=-0.745, -0.612, -0.791, respectively; all, P<0.01). Conclusions Serum concentrations of h-FABP and BNP can be used as biomarkers to evaluate the severity of chronic heart failure. Key words: Heart failure, chronic; Fatty acid-binding protein, Heart-type; Brain natriuretic peptide; heart function; Changes; Correlation; Biomarkers; Children