Objective: In chronic heart failure, lower cholesterol levels have been associated with increased mortality. The relationship between cholesterol levels and in-hospital mortality in patients hospitalized with acute heart failure has not been studied in detail. Methods: A total of 109 (69.7% were males and 30.3% were females) patients were included in this study. The clinical diagnosis of acute heart failure by Framingham criteria with a duration of symptoms less than seven days were included in the study. The baseline blood investigations were analyzed. Statistical Package for the Social Sciences (SPSS) software V 19.0 was employed and p < 0.05 is considered to be statistically significant. Results: The most commonly associated co-morbidity in our study population was ischemic heart disease followed by diabetes mellitus and hypertension. LDL value was found to be less than 100 among 18 of the 20 non-survivor (p=0. 006). HDL value was less than 50 for all the non-survivors. Conclusion: This study provides new insights into the relationship between lipid levels and in-hospital clinical outcomes from a small subset of patients hospitalized with HF in a south Indian state of India and including patients with preserved systolic function and multiple comorbidities.