Spirituality, including both spiritual well-being and spiritual practices, is important to assess in older persons hospitalized with acute heart failure. Depressive symptoms in this population are commonly exhibited but infrequently assessed. The purpose of this exploratory study was to describe spiritual well-being and spiritual practices in hospitalized older heart failure patients and relate spiritual well-being to depression. The sample included 24 hospitalized older adults diagnosed with Class III or IV heart failure. The spiritual practices used most by the older persons were identified. There was a significant negative correlation between spiritual well-being and depression: those who had more depressive symptoms had a lower level of spiritual well-being. Implications for future research and clinical practice are addressed.