Abstract：Objective：To observe the characteristics of tongue manifestation in 181 cases of patients with chronic heart failure (CHF)，and to explore its relationship with New York Heavy Artillery(NYHA) cardiac function classification. Methods： Traditional inspection of the tongue of Chinese medicine was applied to collect the tongue diagnosis data of 181 patients with CHF，including tongue color，form of the tongue， coating color，and texture of coating. The characteristics of tongue body and tongue coating in patients with different cardiac function grades were compared. Results：①According to the distribution frequency from high to low， the tongue color included bluish purple tongue， crimson tongue， red tongue， pale red tongue， and pale tongue. Patients with NYHA cardiac function grade Ⅱmainly had pale red tongue， and patients with cardiac function grade Ⅲ and Ⅳ mainly had bluish purple tongue. There were significant differences in the distribution of tongue color among patients with different NYHA cardiac function grades (P＜0.05). Pairwise comparison showed that the rate of pale tongue in patients with cardiac function gradeⅡ andⅢwas lower than that in patients with cardiac function gradeⅣ(P＜0.05)，the rate of pale red tongue in patients with cardiac function gradeⅢand Ⅳ was lower than that in patients with cardiac function gradeⅡ (P＜0.05)， and the rate of bluish purple tongue was higher than that in patients with cardiac function grade Ⅱ(P＜0.05). ②According to the distribution frequency from high to low， the form of the tongue included fissured tongue，thin tongue，enlarged tongue，and normal tongue. Patients with NYHA cardiac function grade Ⅱmainly had thin tongue， and patients with cardiac function grade Ⅲ and Ⅳ mainly had fissured tongue. There were significant differences in the distribution of the form of the tongue among patients with different NYHA cardiac function grades (P＜0.05). Pairwise comparison showed that the rate of normal tongue in patients with cardiac function grade Ⅲ and Ⅳ was lower than that in patients with cardiac function grade Ⅱ(P＜0.05)， and the rate of fissured tongue was higher than that in patients with cardiac function grade Ⅱ(P＜0.05). ③According to the distribution frequency from high to low， the coating color included yellow coating， gray and black coating， and white coating. White coating was mainly found in patients with cardiac function grade Ⅱ ； yellow coating， and gray and black coating were common in patients with cardiac function gradeⅢ；gray and black coating was more common in patients with cardiac function gradeⅣ. There were significant differences in the distribution of coating color among patients with different NYHA cardiac function grades (P＜0.05). Pairwise comparison showed that the rate of white coating in patients with cardiac function grade Ⅲ and Ⅳ was lower than that in patients with cardiac function grade Ⅱ (P＜0.05)， and the rate of gray and black coating was higher than that in patients with cardiac function grade Ⅱ (P＜0.05). ④ According to the distribution frequency from high to low， the texture of coating included less/no coating， slimy coating， thick coating， and thin coating. Patients with NYHA cardiac function grade Ⅱ mainly had thin coating，and patients with cardiac function grade Ⅲ and Ⅳ mainly had less/no coating. There were significant differences in the distribution of the texture of coating among patients with different NYHA cardiac function grades (P＜0.05). Pairwise comparison showed that the rate of thin coating in patients with cardiac function grade Ⅲ and Ⅳ was lower than that in patients with cardiac function grade Ⅱ (P＜0.05)， and the rate of less/no coating was higher than that in patients with cardiac function grade Ⅱ (P＜0.05)；the rate of slimy coating in patients with cardiac function grade Ⅳ was higher than that in patients with cardiac function grade Ⅱ (P＜0.05). ⑤According to the distribution frequency of moistening degree of tongue coating from high to low， it included dry coating and moist coating. Moist coating was mainly found in patients with cardiac function grade Ⅱ，and dry coating was more common in patients with cardiac function grade Ⅲ and Ⅳ. There were significant differences in the distribution of tongue coating among patients with different NYHA cardiac function grades (P＜0.05). Pairwise comparison showed that the rate of dry coating in patients with cardiac function grade Ⅲ and Ⅳ was higher than that in patients with cardiac function grade Ⅱ (P＜0.05)， and the rate of moist coating was lower than that in patients with cardiac function grade Ⅱ(P＜0.05). Conclusion：Patients with cardiac function grade Ⅲ and Ⅳ were more common with bluish purple tongue， fissured tongue， thin tongue， gray and black coating， less/no coating and dry coating；Patients with cardiac function grade Ⅱoften present with pale red tongue， white coating，thin coating，and moist coating. Tongue diagnosis can be used as an objective evaluation index to evaluate the severity of chronic heart failure.