Patients with ischemic heart failure (iHF) have a high risk of neurological complications such as cognitive impairment and stroke. We hypothesized that iHF patients have a higher incidence of impaired dynamic cerebral autoregulation (dCA). Adult patients with iHF and healthy volunteers were included. Cerebral blood flow velocity (CBFV, transcranial Doppler, middle cerebral artery), end-tidal CO2 (capnography), and arterial blood pressure (Finometer) were continuously recorded supine for five minutes at rest. Autoregulation index (ARI) was estimated from the CBFV step response derived by transfer function analysis using standard template curves. Fifty-two iHF patients and 54 age-, gender-, and BP-matched healthy volunteers were studied. Echocardiogram ejection fraction was 40 (20- 45) % in iHF group. iHF patients compared to control subjects had reduced EtCO2 (34.1 ± 3.7 vs. 38.3 ± 4.0 mmHg, p<0.001) and lower ARI values (5.1 ± 1.6 vs. 5.9 ± 1.0, p= 0.012). ARI < 4, suggestive of impaired CA, was more common in iHF patients (28.8% vs. 7.4%, p = 0.004). These results confirm that iHF patients are more likely to have impaired dCA in comparison with age-matched controls. The relationship between impaired dCA and neurological complications in iHF patients deserves further investigation.