Abstract: Objective To explore the clinical significance of chest computed tomography(CT)signs in the diagnosis of heart failure. Methods A total of 216 patients with suspected heart failure examined by chest CT were selected. Taking the results of color Doppler ultrasound as gold standard, the diagnostic results and imaging manifestations of chest CT were observed. Results The accuracy of chest CT examination was 95.96%(190/198), there were 184 cases with chronic heart failure and 6 cases with acute heart failure. The main clinical signs were pulmonary hypertension interstitial pulmonary edema, cardiogenic pleural effusion, enlargement of heart and pulmonary alveolar edema. Most patients with chronic heart failure showed interstitial pulmonary edema, thickening of interlobular septum and bronchial wall. Those with acute heart failure presented alveolar pulmonary edema, and the inner zone of bipulmonary field presented as patchy or cloudy opacity. Conclusion Chest CT signs can effectively diagnose heart failure, and has higher accuracy.