Introduction (relevance). The problem of demographic ageing is very relevant today. According to experts, this trend will continue in the long term. As the population ages the number of patients with chronic heart failure (CHF) increases exponentially. Objective. To optimize differential diagnostic approach to CHF patients of old age. Materials and Methods. The set of literary data for the last 10 years was studied. Research methods: The solution of the tasks set in writing this article was carried out on the basis of applied general scientific research methods, including methods of interpretation, comparison, generalization within the framework of bibliographic analysis. Results. Highly specific and sensitive diagnostic methods were identified and systematized in elderly CHF patients. Discussion. The modern methods of laboratory diagnostics used in elderly and senile patients with CHF are important for correct diagnosis along with the use of clinical symptomatology and a number of instrumental investigations. Conclusions. The use of laboratory tests in verification of CHF allows not only making the correct diagnosis but also predicting the course of CHF and estimating the results of treatment in elderly patients.