Objective To explore the lived experience of symptom management in patients with heart failure (HF), and to provide reference for optimizing symptom management strategies. Methods Semi-structured interviews were conducted among 17 patients with HF, then data were transcribed and analyzed to identify themes. Results Four themes were determined: symptom perception, symptom distress, knowledge deficit, and thoughts/feelings of symptom management. Conclusion Perception of symptom management is at general level in patients with HF. They have difficulty in symptom identification, knowledge deficit and negative coping mode. Nursing staff need to pay attention to and provide targeted intervention, thus to enhance their symptom management ability and quality of life.