Background: Kidney is not only an excretory organ. It also is an endocrine organ. Kidney produce the hormone called erythropoietin. This hormone is used to stimulate erythropoiesis. In the absence of kidney’s function, erythrocyte production will be greatly reduced, resulting in anemia. To overcome this, there have been drugs called erythropoiesis-stimulating agents (ESA). ESA shown to improve anemia in patients who have terminal renal failure. But the deaths caused by disorders of the cardiovascular system in patients with terminal renal failure increases. This study aims to find the relationship between the incidence of congestive heart failure (CHF) and history of ESA therapy in patients with terminal renal failure. Methods: Case-control study that enrolled 40 patients (20 patients in each group). Subjects of this study are terminal kidney failure patients undergoing regular hemodialysis at RS PKU Muhammadiyah Yogyakarta Unit 2. The independent variable is history of ESA therapy and dependent variable is CHF. I analysed the data using Fisher's exact test. Result: Fisher analysis results show significance value of 0,004 and the odds ratio can not be defined (absolute). Conclusion: There is a relationship between the incidence of CHF with a history of ESA therapy in patients with terminal renal failure.