Heart failure (HF) affects about 23 million people worldwide, of whom 5% are in the advanced stages of the disease and 50% are over 65 years. According to WHO 2011 data, about 7 million people with cardiovascular diseases are candidates for palliative care, but the number of people with these needs is still far below ideal. To analyze the EOL care of HF patients in a private general hospital. Retrospective observational study, with a review of medical records of patients diagnosed with HF, who died in 2016 in a tertiary private hospital in São Paulo, Brazil, focusing on the last 48 hours of life. Of the 423 deaths occurred in the hospital, 60 had a diagnosis of HF. Among HF deceased patients, 68% were men, 50% were between 75 and 90 years-old, 66% had four or more comorbidities and 63.3% of the deaths occurred in an intensive care unit. When the symptoms were analyzed, dyspnea was the most prevalent, occurring in 53% of the cases, while only 21% had a registry of pain. Noninvasive mechanical ventilations was used in 60% of cases, opioids in 67%, inotropic in 33% and vasopressors in 60%. CDI remained activated in 3.3% of patients and were disabled in 5%, while 11% of patients died receiving extra-corporeal devices for circulatory assistance (ECMO, intra-aortic balloon, etc). When the goals of care were analyzed, 40% of the cases were ordered to not perform CPR. The data presented in our study suggest a potential for the growth of palliative care in cases of heart failure, both in the approach to the patients preferences about end of life care, and a better control of their symptoms.