It is uncertain whether hospitalization among patients with congestive heart failure (CHF) increases during the influenza season. This retrospective cohort study used influenza surveillance data from the United States (1986–1987 to 1990–1991), clinical information from the Studies of Left Ventricular Dysfunction (SOLVD) database, and daily temperature data from the National Climatic Data Center to assess the effect of influenza season on hospitalizations in this cohort of patients. The overall hospitalization rate was higher during influenza seasons compared to non-influenza seasons [relative risk (RR) 1·08, 95% confidence interval (CI) 1·01–1·16]. Multivariable Cox modelling revealed an adjusted hazard ratio (HR) of 1·11 for hospitalization during the influenza season (95% CI 1·03–1·20,
P=0·005). Overall death rates were also higher during influenza seasons than non-influenza seasons (RR 1·09, 95% CI 0·97–1·21), but the corresponding adjusted HR for death was not significant (HR 1·01, 95% CI 0·98–1·24, P=0·11). Patients with CHF have a greater risk of hospitalization during the influenza season than in the non-influenza season, supporting the current belief that patients with CHF should be regarded as a high-risk group.