In 7 patients with chronic heart failure (CHF) and 6 controls we examined: a) resting and post-exercise muscle vascular endothelial growth factor (VEGF) mRNA levels, and b) their relationship with muscle structure and function. Muscle biopsies were taken after 30 min of single leg knee-extensor exercise at 50% of maximum work rate (50% WRmax) from both the exercised and rested legs. Muscle blood flow (Q. ) and O2 uptake V̇O2 were measured during exercise. Resting VEGF mRNA levels were not different between patients and controls and both groups upregulated VEGF mRNA equally in response to acute exercise. Patients had lower Q., V̇O2 and mitochondrial density, but similar capillarity and fiber area. These findings reveal a normal basal level of muscle VEGF mRNA, its appropriate upregulation in response to acute exercise and, despite increased vascular resistance during exercise, a normal skeletal muscle vascular structure in patients with CHF.