Objective: Acute heart failure (AHF) is a life-threatening clinical syndrome characterized by rapid onset of heart failure (HF) symptoms and signsand requires urgent therapy. The aim of the present study was to evaluate the overall clinical characteristics, management, and in-hospital outcomes of hospitalized patients with AHF in a large sample of Turkish population.Methods: The Journey HF-TR study is a cross-sectional, multicenter, non-invasive and observational trial. Patients who were hospitalized witha diagnosis of AHF in the intensive care unit (ICU)/coronary care unit and cardiology wards between September 2015 and September 2016 wereincluded in our study.Results: A total of 1606 (male: 57.2%, mean age: 67.8±13 years) patients who were diagnosed with AHF were enrolled in the study. Seventeenpercent of the patients were admitted to the hospital with a diagnosis of new onset AHF. Hypertension (67%) and coronary artery disease (CAD)(59.6%) were the most frequent underlying diseases. Acute coronary syndrome accompanying HF (14.7%), infection (29.3%), arrhythmia (25.1%),renal dysfunction (23%), and non-compliance with medication (23.8%) were the precipitating factors. The median length of stay in the ICU was 3days (interquartile range, IQR 1–72) and 7 days (IQR 1–72) for in-hospital journey. The guideline recommended medications were less likely usedin our patient population (<73%) before admission and were similar to European and US registers at discharge. The in-hospital mortality ratewas 7.6%. Hypertension and CAD were the most frequent underlying diseases in our population similar to other European surveys. Although ourstudy population was younger than other registers, in-hospital mortality was high.Conclusion: Analyses of such real-world data will help to prepare a national database and distinctive diagnosis and treatment algorithms andto provide observing compliance with the current European Society of Cardiology guidelines for more effective management of HF. (Anatol JCardiol 2019; 21: 25-30)