Objective To investigate the level of self-management behavior in heart transplant recipients post-surgery and analyze the influencing factors, so as to provide a reference for developing targeted interventions. Methods A convenience sampling method was employed to select 161 heart transplant recipients who were undergoing outpatient follow-up as research subjects. Data were collected using a general information questionnaire, the Chronic Disease Self-Management Behavior Scale, the Chronic Disease Self-Efficacy Scale, the Hospital Anxiety and Depression Scale, the Social Support Rating Scale, and the 12-Item Short Form Health Survey. Results The average score for self-management behavior among heart transplant recipients was (18.45±4.63). Multiple linear stepwise regression analysis indicated that, self-efficacy, time since surgery, social support, depression levels, quality of life, and educational background significantly influenced self-management behaviors (all P<0.05), explaining a total variance of 82.8%. Conclusion Heart transplant recipients exhibit low levels of self-management behavior, which is influenced by multiple factors. Health care professionals should focus on enhancing recipients′ self-efficacy and social support levels while paying timely attention to their quality of life and psychological status,additionally, tailored guidance should be provided based on the recipient's time since surgery and educational background to improve their self-management behavior level.