<p>Previous studies have reported that the clinical features of chronic heart failure (CHF), such as symptoms, prognosis, mental distress, and quality of life (QOL), differ between men and women. However, no studies have shown sex disparities in distress, which has been assessed by multiple indicators in patients with CHF. This study evaluated sex disparities in physical and mental distress among patients with CHF. This prospective multicenter cross-sectional study included outpatients with CHF. Clinical characteristics such as age, sex, and echocardiography findings were extracted from the medical records. Anxiety/depression, selfcare ability, and QOL were assessed using the Hospital Anxiety and Depression Scale (HADS), the European Heart Failure Selfcare Behavior Scale (EHFScBS), and Short Form-12 (SF-12), respectively. The mean age of the participants was 69.7 ± 11.9&#xa0;years, and 28.3% of the 251 patients were female. The mean left ventricular ejection fraction (LVEF) was 52.0 ± 13.9%, and LVEF was higher in women. The most common underlying disease was ischemic heart disease (38.3%). Multivariate analysis showed that women had significantly higher levels of anxiety/depression, lower mental component summary scores, and reduced physical functioning in terms of QOL, whereas selfcare ability did not differ between women and men. The findings of this study suggest that women have significantly more anxiety/depression and worse physical and mental QOL than men. Thus, more attention should be paid to psychological disorders, including QOL, during CHF management, especially in women.</p>