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Although patients with heart failure (HF) may suffer from severe thirst, this has received little attention in scientific studies. A systematic literature review was conducted to identify and analyse data on thirst in HF.Pubmed, Cochrane, Cinahl, and Medline databases were searched for original studies on patients with HF with thirst as an outcome measure. Of 174 screened citations, nine articles were included, in which a total of 4375 HF patients had been studied. Four studies comprising 181 patients provided visual analogue scale (VAS) scores. Median thirst intensity ranged from 23 to 75 mm (VAS 0–100 mm). One study showed 2% prevalence of thirst in a placebo group and another study showed that 46% of HF patients (n = 25) experienced thirst distress. Thirst was described as annoying and as a cause of suffering. In most studies, the main results reflect a poor description of several dimensions of thirst. Factors that affected thirst were related to treatment, HF condition, demographics, and emotions. The consequences of thirst in HF were related to compliance, preoccupation with thirst, and a negative impact on quality of life.Thirst may be increased and experienced as distressing in patients with HF, but there is limited knowledge about the causative factors. More research is needed to study the effects of thirst and effective interventions in order to relieve troublesome thirst in HF patients.