Background: We were conducted this study to assess the prevalence of food insecurity in heart failure patients households and the relationship between food security and some variables in this households. Methods: In this cross sectional study, a total of 300 heart failure patients' households were studied in Imam Reza hospital of Mashhad. The Iranian version of household food insecurity access scale was used to measure food security. Results: Among the participants in this study, 129 patients (43%) were secure, 42 patients (14%), 82 patients (27.3%) and 47 patients (15.7%) were mild, moderate and sever insecure, respectively. Chi-square test results show that there is a strong association between diabetes, hypertension, body mass index (BMI), and food security distribution (P < 0.01). Conclusions: Based on our findings, food insecurity is mild to severe prevalent in heart failure patients households, meanwhile there is a strong relationship between diabetes, hypertension, BMI and food security status, so it is important to assess their food status and prevent from worsening their nutritional status