ABSTRACT Introduction: Heart failure is an ultimate clinical outcome, resulted from functional dysfunction of ventricular filling or ejection of blood resulting the inability of the heart to pump adequate amount of blood to meet the demands of the body. It is the most rapidly growing cardiovascular disease globally, conferring substantial burden on health care systems worldwide. Objective: The general objective of this study is evolutions of pulse rate and respiratory rate with time to death of heart failure patients and identifies the risk factor of heart failure patients using joint modeling of longitudinal and survival model at Debre Tabor referral hospital. Method: Retrospective study design was used from Debre Tabor referral hospital. The data was collected from heart failure patient’s chart from 1 st January 2016 to 31 th December 2019. The Kaplan-Meier survival estimate and Log-Rank test were used to compare the survival time. Joint model of bivariate longitudinal and time to event model was used to identify factors of longitudinal change of pulse rate and respiratory rate with time to death jointly. For the longitudinal part linear mixed effect model and for the survival part Cox PH model were used. Result: As the follow up time of heart failure patients increase by one month the average longitudinal change of pulse rate and respiratory rate decreased by 0.099 bpm and 0.046 bpm. Male heart failure patients increased the average change of pulse rate and respiratory rate by 6.40 bpm and 2.86 bpm respectively as compared to females. Residence of urban patients had 0.139 times high risk of death as compared to rural patient. Male patients had 2.913 times high risk of death as compared to female patient. Congestive heart faliure patient who have DB disease had 8.62 times high risk of death as compared to non-DB disease. Conclusion: the predictors of gender, age, diabetes mellitus, left ventricular ejection fraction, and New York heart association class were risk factor of death on congestive heart failure. Gender, residence, age, congestive heart failure type, New York heart association class, follow up time and diabetes mellitus were factor of pulse rate. Gender, residence, New York heart association class, follows up time and diabetes mellitus were factor of respiratory rate. Health professionals are recommended to provide more attention for heart failure patients whose pulse rate and respiratory were high. Keywords: Congestive Heart Failure, Joint Model, Pulse Rate, Respiratory Rate