Heart failure is a growing public health problem among elderly population. Even if treated, its prognosis remains generally very poor with high mortality (40% within a year from diagnosis) and a significant level of morbidity. Although substantial health inequalities have been documented, our knowledge of epidemiology and clinical outcomes in minority patient groups is still very limited. This study aimed to test a hypothesis of poorer prognosis among South Asians in the UK on a background of clinical outcomes in an unselected population. As the first large study to describe heart failure outcomes in a multi-ethnic, contemporary population, the report presents epidemiological trends and long-term survival, with a particular focus on the South Asian minority. The results show that despite the higher cardiovascular risk, younger age at first admission and higher rate of hospitalisation, the clinical outcomes among South Asians are similar to those in other ethnic groups.