Objective：To evaluate the volume status and its impact on prognosis in heart failure patients with reduced ejection fraction（HFrEF）. Methods：Prospective and consecutive patients hospitalized in Department of Cardiology of the First Affiliated Hospital of Nanjing Medical hospital due to the diagnosis of HFrEF from 2017 to 2022 were enrolled. Estimated plasma volume（PV） was used to assess the patient’s volume load status，and divide the patients into low，medium，and high-volume load groups based on tertiles methods. Correlation analysis was used to evaluate the correlation between PV and classic volume load markers；Kaplan-Meier method was used to plot survival curves，and both univariate and multivariable COX regression analysis were performed to evaluate the correlation between volume load status and prognosis of HFrEF. Results：This study included 233 patients with an estimated PV of （4.26 ± 1.08）L. There is a clear correlation between PV and pro B-type natriuretic peptide（proBNP）. After a median follow-up of 25 months，90 patients experienced cardiovascular death and worsening heart failure requiring readmission. After adjusting for multiple factors including age，systolic blood pressure，proBNP，renal function，and New York Heart Association（NYHA）grading，compared to the low -volume load group，the medium and high volume load groupshad a hazard ratio of 1.78（0.94-3.36）and 2.74（1.45-5.16）， respectively，for cardiovascular death and worsening heart failure. Conclusion：The assessment of volume load status in patients with HFrEF shows that high-volume load is an independent risk factor for the prognosis of HFrEF patients.