The purpose was to assess the nutritional characteristics of patients repeatedly hospitalized with acute heart failure (AHF). We enrolled 60 patients with hospitalized at least three times within four years. The Geriatric Nutritional Risk Index (GNRI) was used as a nutritional index. The patients were divided into three groups based on changes in GNRI: (1) Good group, good or mild decrease in nutritional status (GNRI ≥ 92); (2) Change group, nutritional status changed; and (3) Poor group, moderate to severe malnutrition status (GNRI <92). Of the 60 patients, there were 23 in the Good group (38.3%), 23 in the Change group (38.3%), and 14 in the Poor group (23.4%). The overall GNRI decreased at every hospitalization. The rate of cognitive impairment (CI) was highest and handgrip strength was lowest in the Poor group. In multivariate analysis, CI was independently associated with the Poor group. The patients with persistent malnutrition were characterized by CI.