ABSTRACT Background: The existence of atrial fibrillation, Ventricular arrhythmias, Stroke, hypotension, myocardial infarction and acute renal failure as among the most common complications of congestive heart failure, it is the global health issue. Moreover, the relationship between the effects of different variables on CHF control and the longitudinal mean arterial pressure changes has not been adequately clarified. Thus, the main objective of this study was identifying factors jointly affecting longitudinal change of mean arterial pressure and time to complication of congestive heart failure patients treated at Felege Hiwot Comprehensive Specialized Referral Hospital, Bahir Dar, Ethiopia. Method: A retrospective cohort study was conducted with 218 randomly selected congestive heart failure patients from outpatient’s clinic at Felege Hiwot Comprehensive Specialized Referral Hospital. The joint model consists of linear mixed effects sub model for the longitudinal mean arterial pressure and cox proportional hazards sub model for the time to complication of congestive heart failure patients. Result: The baseline mean arterial pressure was 84.7767±11.76193mmHg. Estimates from the joint model were more efficient via their smaller standard errors compared to the corresponding results from separate models. New York heart association classes of congestive heart failure patients has a direct effect on the inverse of mean arterial pressure and the risk complication. In addition, the estimated association parameter (α) in the joint model was 0.05964 (p value <0.0001). Conclusion: age, New York Heart Association classes, left ventricular ejection fraction, serum sodium concentration, serum hemoglobin concentration and residence were significantly associated with the mean arterial pressure and time to complication of congestive heart failure patients. Health professionals and the concerned bodies should give more attention for elders and congestive heart failure patients with New York Heart Association class IV symptoms during the follow-up times to normalize their mean arterial pressure and to minimize the risk of complication. Keywords: mean arterial pressure, time to complication, joint model