Background: Heart failure is a prevalent and chronic condition with a rising incidence globally, including in India. Red cell distribution width (RDW), a measure of erythrocyte size variation, has been proposed as an indicator of inflammation and oxidative stress in cardiovascular diseases, including heart failure. However, limited data exist on the relationship between RDW and heart failure severity in Indian patients. This study aimed to investigate the correlation between RDW and the severity of heart failure in Indian patients. Result: The study included patients across various age groups, with the majority falling in the 51-60 years range, and most of the patients were male. Hypertension was the most common risk factor for heart failure, followed by dyslipidemia and obesity. Ischemic heart disease emerged as the primary cause of heart failure in the studied population. Distribution of patients based on NYHA classes revealed a higher percentage in the more severe classes (III and IV). The mean RDW was significantly higher in patients with advanced heart failure compared to those with milder forms. Conclusion: The study findings indicate a correlation between elevated RDW and increased severity of heart failure in Indian patients. RDW shows potential as a biomarker for risk stratification and monitoring disease progression in this population. Further research is needed to explore the clinical utility of RDW in the early detection and management of heart failure, along with its implications for developing new therapeutic approaches specific to the Indian context.