Objective To investigate the current status of health literacy of elderly patients with chronic heart failure (CHF) and their caregivers, and to explore the effects of their literacy levels on patient′s self-care. Methods Convenience sampling was used to select 500 caregivers and 500 elderly CHF inpatients who were hospitalized in 3 tertiary general hospitals in Zhengzhou City. Surveys were conducted using the general information questionnaire for the patients and their caregivers, Chinese version of the HF specific health literacy scale, 2009 Chinese citizen health literacy questionnaire, the Chinese version of the heart failure self-care behavior scale. SPSS statistics 22.0 was used for data analysis. For different data types, student′s t test or Chi-square test were employed for intergroup comparison. Pearson correlation analysis was adopted to analyze the correlation between health literacy and self-care ability of patients and caregivers. Multiple linear regression analysis was performed to determine the effect of health literacy on self-care ability of patients. Results Pearson correlation analysis showed that the levels of patient and caregiver health literacy were positively correlated with the patient′s self-care behaviors (r=0.757,0.655, both P<0.01). Multiple linear regression analysis indicated that the health literacy levels of elderly CHF patients (β=0.405, P<0.05) and their caregivers (β=0.292, P<0.01) were main influencing factors for patient′s self-care. Conclusion Improving the health literacy levels of elderly CHF patients and caregivers can promote the self-care behaviors of patients. We should pay attention to and assess their health literacy levels. The caregivers should be included in the heart failure treatment and care team in order to initially establish a health education framework for the caregivers. And the health literacy intervention program suitable for both sides should be further studied so as to improve the self-care ability of patients and improve the outcome of heart failure.