Background: Chronic heart failure (CHF) is a major global health concern associated with high morbidity and mortality. Echocardiography is a non-invasive, cost-effective, and widely available tool for diagnosis, prognosis, and treatment planning in CHF. Aim: To assess the role of echocardiography in evaluating structural and functional abnormalities in patients with chronic heart failure. Methods: A prospective observational study was conducted on 100 patients diagnosed with chronic heart failure. Echocardiographic parameters including ejection fraction (EF), left ventricular function, valvular abnormalities, diastolic dysfunction, pulmonary artery pressure, and chamber dimensions were analyzed. Results: Reduced ejection fraction (<40%) was found in 62% of cases. Diastolic dysfunction was present in 70% of patients. Left ventricular hypertrophy (48%), dilated chambers (55%), and valvular regurgitation (42%) were commonly detected. Echocardiography findings significantly correlated with NYHA functional class. Conclusion: Echocardiography plays a crucial role in diagnosis, classification, prognosis, and follow-up of chronic heart failure patients. It should be considered an essential investigation in all suspected and confirmed CHF cases.