INTRODUCTION AND OBJECTIVES: The aim of this study is to assess the safety in a real-world cohort of patients with heart failure with reduced ejection fraction (HFrEF). METHODS: Observational, retrospective and single-center study with patients on vericiguat treatment from the Cardiology and Internal Medicine outpatient clinic of the Valencia General University Hospital Consortium during 2023 year and with minimum follow-up of 6 months. Patients with HFpEF diagnosis and optimized treatment according to the ESC 2021 clinical practice guidelines were included, to whom treatment with vericiguat was started. RESULTS: We included 123 patients with a mean age of 78 years, mostly men (62%) and with NYHA II functional status (52%). 98 patients completed follow-up after a median follow-up of 162 days (IQR 13-343). The average dose of vericiguat used was 8,3 ± 2,7 mg and 75 patients achieved the target dose of 10 mg (71%). At the end of follow-up, no significant changes were observed in the values of proBNP (pg/mL), CA125, hemoglobin (mg/dl), electrolytes, glomerular filtration rate (mL/min/m CONCLUSIONS: The use of vericiguat is safe, if used according to the technical data sheet, in terms of the established parameters. Further long-term studies are needed to evaluate the impact of vericiguat as a potential disease-modifying treatment.