The beneficial impacts of metabolic surgery (MS) on patients with heart failure (HF) are incompletely characterized. We aimed to describe the cardiac and metabolic effects of MS in patients with HF and hypothesized that patients with HF would experience both improved metabolic and HF profiles utilizing glycemic control and diuretic dependency as surrogate markers. In this single-center, university-affiliated academic study in the United States, a review of 2,342 hospital records of patients undergoing MS (2017-2023) identified 63 patients with a medical history of HF. Preoperative characteristics, 30-day outcomes, and up to 2-year biometric and metabolic outcomes, medication usage, and emergency department utilization were collected. At 24-months, mean body mass index (BMI) change was -16 kg/m2 (p<0.001) that corresponded to a mean % total body weight loss (%TBWL) of 29% (p<0.001). Weight loss was accompanied by significant reductions in hemoglobin A1c (HbA1c) (p<0.001), as well as a 65% decrease in diuretic use at 24-months postoperatively (p<0.001). Similarly, emergency visits for cardiac-complaints (p=0.06) and IV-diuresis (p=0.07) trended favorably at 1-year post-op compared to 1-year pre-op, but were not statistically significant. In conclusion, in carefully selected patients with HF, MS appears to provide significant reduction in oral diuretic dependency and metabolic improvements with trends toward lower rates of ED-utilization.