Objective To analyze the incidence, clinical features of pericardial effusion(PE) in patients with chronic heart failure(CHF) and the related risk factors. Methods A prospective multicenter study was performed. A total of 1382 patients with the diagnosis of CHF were enrolled in this study. M-mode echocardiography was carried out to determine the presence or absence of PE and to semi-quantify its volume. The incidence of PE in patients with CHF and its relationship with other clinical parameters were analyzed using univariate and multivariate logistic regression analysis. Results The incidence of PE was 9.92%(118/1382) in patients with CHF. Among which, moderate PE accounted for 90.68%(107/118), small PE 6.78% (8/118), and large PE only 2.54%(3/118). M-mode echocardiography revealed that no patient suffered from severe tamponade. Logistic analysis showed that higher systolic blood pressure(SBP) (OR = 1.04, 95%CI 1.01–1.07, P = 0.043), lower left ventricular ejection fraction(LVEF) (OR = 1.09, 95%CI 1.02–1.15, P = 0.032) and larger main pulmonary artery diameter(MPAD) (OR = 1.51, 95%CI 1.24–1.85, P＜0.001) were independent risk factors of PE in CHF patients. Conclusion PE is a relatively common presentation in CHF patients, and small to moderate PE are most frequent. PE is not related to the etiology of CHF while is strongly associated with higher SBP, lower LVEF and larger MPAD.