INTRODUCTION    Heart failure (HF) is the leading cause of hospitalization in elderly patients. OBJECTIVES    The aim of the study was to examine the clinical profile and 1‑year outcomes of elderly patients (aged ≥65 years) compared with younger patients (aged <65 years) hospitalized for HF decompensation, as well as clinical differences among elderly patients aged 65–74 years and those aged ≥75 years. PATIENTS AND METHODS    The primary endpoint (PE; all‑cause death) and the secondary endpoint (SE; all‑cause death or rehospitalization for HF worsening) were assessed at 1 year in a group of 765 hospitalized Polish participants of the ESC‑HF Long‑Term Registry. RESULTS    The PE was observed in 9.1% of patients aged <65 years; 18.5% of those aged ≥65 years (P = 0.0001); 14.5% of those aged 65–74 years; and 21.6% of those aged ≥75 years (P = 0.07). The SE occurred in 28.0% of patients aged <65 years; 36.1% of those aged ≥65 years (P = 0.04); 29.2% of those aged 65–74 years; and 41.2% of those aged ≥75 years (P = 0.01). Independent predictors of the PE in patients aged ≥65 years were as follows: chronic obstructive pulmonary disease (COPD), systolic blood pressure (SBP), New York Heart Association (NYHA) class, β-blocker use; in patients aged 65–74 years: coronary revascularization, NYHA class, sodium, and creatinine; in patients aged ≥75 years: NYHA class and SBP. Independent predictors of the SE in patients aged ≥65 years were as follows: COPD, NYHA class, potassium, SBP, and physical activity; in patients aged <65 years: chronic kidney disease (CKD), NYHA, and SBP; in patients aged 65–74 years: NYHA and creatinine; and in patients aged ≥75 years, previous HF hospitalization, coronary artery disease, CKD, COPD, alcohol consumption, smoking, NYHA, and SBP. CONCLUSIONS    Elderly patients with HF differed from younger patients in terms of long‑term outcome and prognostic factors. There were also important differences within the elderly group itself.