Abstract: Heart failure is a complex clinical syndrome caused by various causes and disease progression. The causes of heart failure in pediatric patients are significantly different from those in adult patients. Congenital heart disease and primary cardiomyopathy are the main causes in pediatric heart failure patients. This article will review the research progress in the pathogenesis of heart failure in pediatric patients in recent years from the aspects of hemodynamic changes, genetic and epigenetic factors, and other mechanisms including molecular structure and neurohormones.