Abstract: Objective To study the effect of renal insuffciency on clinical outcomes in heart failure (HF) patients after resynchronize therapy. Methods Fifty-one consecutive HF patients who undewent resynchronize therapy in our hospital from 2007 to 2012 were retrospectively analyzed. The patients were divided into renal insuffciency group with its GFR< 60 ml/min and normal renal function or mild renal function impairment group with its GFR≥60 ml/min. Their clinical outcomes after resynchronize therapy were compared. Results The patients were followed up for an average period of 31.4 months. The all-cause mortality and the number of end point events were signifcant higher in renal insuffciency group than in normal renal function or mild renal function impairment group (P=0.02, P=0.001). Cox regression analysis revealed that the GFR, LVEDD, ACEI and ARB were closely related with the all-cause mortality and hospitalization rate in HF patients. Conclusion Renal insuffciency in HF patients increases their mortality and hospitalization rate after resynchronize therapy.