Introduction: Heart failure (HF) is a leading global health problem affecting more than 64 million people worldwide. Co-existing cardiovascular renal and metabolic (CVRM) diseases confer poorer prognosis with an increased risk of outcomes. Although Middle East and Africa (MEA) region bears a disproportionately high burden of CVRM diseases, there is a scarcity of real-world data on patients’ characteristics, risk factors, and management practices. Aims: To describe the clinical features, comorbidities, and treatment patterns in patients with HF from the MEA-HF cohort of iCaReMe Registry. Methods: iCaReMe Registry is a multinational, prospective, observational study (NCT03549754) collecting data on the management and quality of care of patients with HF, HTN, T2D and or CKD. We included in this baseline cross-sectional analysis data of HF patients enrolled between Feb 2018 and Dec 2022 from 8 countries (Egypt, Ethiopia, Jordan, Kenya, Lebanon, South Africa, Turkey, and United Arab Emirates). Results: : Overall, 2239 adults (mean±SD age of 58.4±12.6 years, 61.7% males) with HF were enrolled. Of the 85.7% patients with available LVEF data, 67.6% had HFrEF; 83.8% had NYHA class II-IV symptoms. Comorbidities included HTN (56.4%), T2D (50.3%), CAD (47.8%), dyslipidemia (33.0%), and CKD (26.5%). Mean UACR was 516.1 mg/g and mean eGFR was 70.7 ml/min/1.73m 2 reported in 13.8% and 80.9% of patients respectively. Overall, 24.1% had history of hospitalization for heart failure. The prescribed treatments at baseline included ACEi/ARB (72.1%), beta-blockers (74.8%), diuretics (65.2%), aldosterone antagonists (45.1%), SGLT2i (41.3%) and ARNI (18.8%). Conclusions: The substantial prevalence of CV comorbidities across the ejection fraction spectrum justifies the need to improve heart failure care with the strengthening of the use of therapies with morbidity and mortality proven benefits.