Heart failure patients with gallstones can be left untreated if they have no symptoms and complications, and if they have clinical symptoms, they can be treated with surgery if the body can tolerate it. If the size and number of gallstones in heart failure patients are small, without clinical symptoms and do not affect their lives, they can choose not to do special treatment and follow up observation. For patients with symptoms or complications, cholecystectomy is the clinically preferred treatment. At present, laparoscopic cholecystectomy is already a routine surgery with mature technology, which has the advantages of small surgical injury and small scar. For complex conditions or hospitals without laparoscopic equipment, open cholecystectomy can also be chosen, but the surgical damage is greater. For patients with heart failure, whether or not surgery can be performed needs to be assessed by the clinician according to the patient’s specific situation, in order to minimize the risk of surgery and reduce the patient’s mortality rate.