Background: Frailty affects the prognosis and management of patients with heart failure, and is often related with sarcopenia. Also, the serum myostatin (MSTN) involved in the development of sarcopenia and frailty. This study aimed to determine the connection between MSTN level and frailty in older adults with chronic heart failure (CHF). Methods: This prospective case-control study enrolled older adult patients with CHF between May 2019 and May 2021, and analyzed their clinical data. Results: In this study 75 older adults with CHF were included, 29 of whom were frail. The B-type natriuretic peptide (BNP) levels were significantly higher in frail older adults with CHF than in older adults with CHF who were not frail (316.82 ± 235.64 pg/mL vs 198.61 ± 112.58 pg/mL; P = 0.016). The MSTN levels were significantly higher in frail participants than in participants who were not frail (2.93 ± 1.35 ng/mL vs 2.24 ± 0.84 ng/mL; P = 0.018). Based on multivariable analysis the BNP (odds ratio [OR] = 1.004, 95% confidence interval [CI] = 1 0.001-1.008; P = 0.018) and MSTN (OR = 1.772, 95% CI = 1.079-2.912; P =0 0.024) levels were independently associated with frailty in older adults with CHF. Conclusion: MSTN is a promising biomarker of frailty in elderly patients with CHF.