Objective To investigate and analyze the correlation of negative emotions and self-perceived burden with quality of life in the elderly patients with chronic heart failure (CHF). Methods A total of 94 non-elderly patients with CHF (non-elderly group) and 122 elderly patients with CHF (elderly group) admitted to the First Affiliated Hospital of Nanjing Medical University from February 2020 to December 2022 were enrolled in the study. The clinical characteristics, negative emotions [self-rating anxiety scale (SAS), self-rating depression scale (SDS)], and self-perceived burden [Chinese Version of Self-Perceived Burden Scale (SPBS)] and quality of life [Minnesota Living with Heart Failure Questionnaire (MLHFQ)] were compared between the two groups. SPSS 22.0 was used for data analysis. According to the data type, t test, analysis of variance, or Chi-square test was employed for comparison between groups. Pearson linear correlation analysis was used to analyze the correlation between negative emotions, self-perceived burden, and quality of life in the elderly CHF inpatients, and multivariate linear regression analysis was employed to analyze the factors affecting their quality of life. Results Compared with the non-elderly group, the elderly group had a higher comorbidity, higher New York Heart Association (NYHA) classes and longer hospital stay; in medication, the elderly group had a lower rate of β-blocker use, a higher rate of digoxin use, and a higher proportion of users of ≥ 3 drugs; the differences were statistically significant (P<0.05). Pearson correlation analysis showed that the scores of SAS, SDS and SPBS in the elderly group were positively correlated with total MLHFQ scores (P<0.05). Multivariate linear regression analysis showed that NYHA classes, CHF course, annual hospitalization frequency, exercise frequency, anxiety, depression, and self-perceived burden were factors affecting the quality of life in the elderly CHF patients (P<0.05). Conclusion Compared with the non-elderly patients, the etiology and comorbidity of the elderly CHF inpatients are more complex, and the CHF is more serious. Anxiety, depression, and self-perceived burden have negative predictive effects on the quality of life in elderly CHF patients.