Objective: This study focuses on the clinical observation of the impact of different treatment methods for gestational heart failure on delivery outcomes. Method: A total of 160 pregnant women with heart failure admitted to our hospital between October 2020 and October 2021 were selected as the study subjects. They were categorized based on delivery mode, delivery timing, heart failure control time, and cardiac function status. The delivery outcomes of the different groups were then compared. Result: In terms of delivery methods, the rate of neonatal asphyxia was higher following vaginal delivery than cesarean section. Regarding delivery timing, the neonatal mortality rate was lower for cesarean sections performed at 32–36 + 6 weeks compared to those conducted at 37–39 + 6 weeks. With respect to heart failure control time, the rates of neonatal asphyxia and pulmonary hyaline membrane disease were lower in the ≤ 48- hour group than in the > 48-hour group. From the perspective of cardiac function status, patients with cardiac function I– II exhibited relatively lower rates of neonatal asphyxia and perinatal mortality compared to those with cardiac function III–IV. The observed differences were statistically significant (P < 0.05). Conclusion: For patients with gestational heart failure, cesarean section is the recommended mode of delivery, with the optimal timing being between 32 and 36+6 weeks of pregnancy. During cesarean section, the timing of delivery should be carefully selected based on the mother’s cardiac function status.