Background: Selfcare is a vital component of heart failure management that is known to improve the outcomes. However, little is known about the status of self-care behaviors among patients with heart failure in Sudan. Objectives: This study aimed to assess the self-care behaviors among Sudanese patients with heart failure at a tertiary hospital in Sudan. Methods: A cross-sectional single-institutional study was conducted across three-month period in 2021. A total of 200 heart failure patients were enrolled, and data was collected through patients’ interview. Descriptive and binary logistic regression analyses were processed to check the effect of different factors on the patients’ adherence levels. Results: Out of 200 heart failure patients, 53.5% were females, and the mean age of patients was 60 (± 13.7 SD) years. Among them, only 4.5% of heart failure patients reported adequate adherence to their self-care recommendations and the mean total score was 42.6 (± SD15.5). Adherence to self-care recommendations wasn’t significantly associated with age, gender, marital status, education level, and comorbidity. Conclusion: In this study, the overall adherence to self-care behavior was found to be extremely low among Sudanese heart failure patients, and selectively adherence to prescribed medications was good. These outcomes put light on a major opportunity for further prospective follow–up studies, which have an intervention approach for each self–care recommendation to improve the heart failure situation in Sudan.