Background <p>Acromegaly-related heart failure, as a rare cause of heart failure, presents a substantial healthcare challenge owing to their insidious onset and overlapping symptoms. Current management often includes systemic anti-heart failure treatment and reducing growth hormone(GH) levels, yet cardiac outcomes remain unideal. Left ventricular assist device(LVAD) may be a valuable therapeutic option in such patients.</p> Case presentation <p>We report a case of a 54-year-old Chinese female diagnosed with severe congestive heart failure, classified as New York Heart Association class IV. The clinical symptom failed to improve, despite systemic anti-heart failure treatment. Heart failure arising from acromegaly was suspected due to her facial features, and confirmed through elevated levels of GH and a pituitary macroadenoma demonstrated by magnetic resonance imaging. Upon diagnosis of acromegaly, bromocriptine was initiated to reduce GH levels. Subsequently, our multidisciplinary team administered LVAD implantation, resulted in cardiac symptoms completely relieved within one week postoperatively. During one-year follow-up, the patient's heart condition remained stable and the GH gradually decreased.</p> Conclusion <p>LVAD may be a valuable therapeutic option in acromegaly-related heart failure patients.</p>