Introduction Heart failure (HF) has 2 major etiologies: ischemic and non-ischemic. We compared patient characteristics and in-hospital outcomes between ischemic cardiomyopathy (ICMP) patients and non-ischemic cardiomyopathy (NICMP) patients hospitalized for heart failure. Methods We selected patients with principle diagnosis of heart failure (ICD-10 codes: I50, I09.81, I11.0, I130, I132) from National Inpatient Sample database 2016 and divided them into 2 groups by secondary diagnosis of ICMP (ICD-10 code: I25.5) or NICMP (ICD-10 codes: I42.0-I42.9). Demographic characteristics and common comorbidities were compared. Primary outcome was in-hospital mortality. Secondary outcomes were cardiogenic shock, cardiac arrest, need for percutaneous ventricular assist device (PVAD) or intra-aortic balloon pump (IABP), acute kidney failure (AKI), respiratory failure, VT/VFib, and need for palliative care. Results There were total 150480 patients in ICMP group and 227935 patients in NICMP group. ICMP group were older and had more male patients than NICMP (Table 1). ICMP group were more likely to have DM, HLD, smoking, HTN, chronic pulmonary disease while NICMP group were more likely to have obesity, VHD, liver disease, OSA, and pulmonary hypertension (Table 1). ICMP group had higher in-hospital mortality (OR 1.22, 95% CI (1.11-1.33), P Conclusion Hospitalized heart failure patients with ICMP had higher in-hospital mortality and more complications (cardiogenic shock, need for PVAD or IABP, AKI, respiratory failure, need for palliative care) than patients with NICMP.