<p>Chronic heart failure (CHF) represents an escalating public health issue characterized by high rates of morbidity, mortality, and increasing healthcare expenditures. Although home-based cardiac rehabilitation (HBCR) has been proven effective in managing CHF, patient engagement remains suboptimal. This study aimed to examine the knowledge, attitudes, and practices (KAP) associated with HBCR in patients with CHF. This cross-sectional study was conducted between April and July 2024 at Jiangxi Provincial People’s Hospital. Data were collected via a questionnaire that included demographic information and assessed participants’ KAP scores. A total of 591 patients with CHF participated in the study. Among them, 349 (59.05%) were male, and 355 (60.07%) had a history of cardiovascular disease. The mean scores for knowledge, attitude, and practice were 7.27 ± 4.43 (range: 0–18), 29.18 ± 5.31 (range: 8–40), and 34.57 ± 5.57 (range: 10–50), respectively, indicating low knowledge but moderate attitudes and practices. Correlation analysis showed significant positive relationships between knowledge and attitude (<i>r</i> = 0.315, <i>P</i> &lt; 0.001), knowledge and practice (<i>r</i> = 0.329, <i>P</i> &lt; 0.001), and attitude and practice (<i>r</i> = 0.502, <i>P</i> &lt; 0.001). Mediation analysis revealed that knowledge had a direct effect on attitude (β = 0.408, <i>P</i> = 0.008) and practice (β = 0.206, <i>P</i> = 0.011), while attitude also directly affected practice (β = 0.440, <i>P</i> = 0.008). Furthermore, knowledge indirectly influenced practice through attitude (β = 0.179, <i>P</i> = 0.006). Patients with CHF demonstrated limited knowledge but moderate attitudes and practices toward HBCR, underscoring the need for enhanced educational interventions. Clinicians are encouraged to implement more comprehensive educational programs that target KAP dimensions to optimize patients’ participation of HBCR.</p>