Aim: To understand gender differences in the prognosis of women and men with heart failure, we compared mortality, cause of death and survival trends over time. Patient characteristics: Aged >45. New diagnosis of heart failure. Diagnosed between 1 January 2000 and 31 December 2017. Number included 29234 men and 26725 women who were diagnosed with heart failure, including 15,084 men who died and 15822 women, within the study period of 17 years. The median age of diagnosis was 74.8 for men, 79.6 for women. The median survival following diagnosis was 4.47 years for men and 3.99 years for women. Cause of death in men: CVD (56.1%), primary heart failure (6.1%), heart failure any (41.8%) and non-CVD (43.9%). Cause of death in women: CVD (55.2%), primary heart failure (8.4%), heart failure any (42.9%) and non-CVD (44.8%). Women had a 14% lower age-adjusted risk of all-cause mortality compared to men. Logos - Oxford University NDPCHS, Wellcome, Funded by NIHR.