Background: Heart failure poses a significant global health burden, necessitating reliable prognostic markers. This study evaluated the utility of soluble ST2 in predicting adverse outcomes in heart failure patients.Methods: A prospective observational study was conducted on 86 heart failure patients. Soluble ST2 levels were measured at admission, and patients were followed for adverse outcomes. Demographic characteristics, clinical parameters, and comorbidities were analyzed.Results: The study population comprised predominantly females (58.1%) with a mean age >60 years (54.7%). Breathlessness was the primary presenting symptom (96.5%), with 43.0% patients in NYHA Class IV. Patients with adverse outcomes demonstrated significantly higher ST2 levels (56.1 ± 22.5 ng/mL vs 26.7 ± 12.2 ng/mL, p<0.001). ROC analysis yielded an AUC of 0.86 (95% CI: 0.78-0.95). Using a 36 ng/mL cutoff, ST2 showed 82.4% sensitivity and 76.9% specificity for predicting adverse outcomes, with an 87% negative predictive value.Conclusion: Soluble ST2 demonstrated significant prognostic value in heart failure, particularly in identifying low-risk patients. The biomarker's high diagnostic accuracy supports its integration into routine clinical assessment for improved risk stratification.