Objective To explore the effect of remote patient management on the prognosis of elderly patients with chronic heart failure. Methods A total of 256 elderly patients with chronic heart failure treated in the geriatric department of our Sixth Medical Center from June 2014 to December 2018 were enrolled, and according to their hospital discharge order, they were divided into a remote management group (n=125) and a routine management group (n=131). SPSS statistics 25.0 was used to perform the statistical analysis. Kaplan-Merier survival curve was performed for all-cause death analysis between groups. Results During a median follow-up time of 25.0 (17.0～38.8) months, 51 patients (19.9%) experienced all-cause death, including 28 deaths due to respiratory infections. All cause mortality was 12.8% (16/125) in the remote management group and 26.7% (35/131) in the routine management group. Compared with the conventional management, telemonitoring could reduce patients′ all-cause mortality (HR=0.403,95%CI 0.210-0.773; P=0.006). The death rates of cardiovascular disease and respiratory infection were lower in the remote management group[4.0%(5/125),7.2%(9/125)] than the routine management group [9.9%(13/131)14.5%(19/131)], though none of the differences were statistically significant(P>0.05). There was no significant difference in the incidence of all-cause rehospitalizations between the two groups (P>0.05). The median time of all-cause rehospitalization and cardiovascular rehospitalization in the remote group were 49.0 and 28.0 d, respectively, which were higher than those of the routine group(28.0 and 0.0 d), respectively, with obvious difference between the two groups (P<0.05). Conclusion Remote patient management could reduce all-cause mortality but increase all-cause rehospitalization and cardiovascular rehospitalization in elderly patients with chronic heart failure.