<p>Sarcopenia is an age-related condition characterized by progressive loss of skeletal muscle mass and function, with its prevalence increasing with age. Currently, there is no globally standardized approach for its diagnosis, assessment, or treatment. Heart failure (HF) is a clinical syndrome resulting from impaired cardiac function due to various cardiac diseases, manifesting primarily as dyspnea and reduced exercise tolerance. Its onset is often insidious and frequently complicated by comorbidities such as sarcopenia. This comprehensive review synthesizes current domestic and international research on the diagnosis and pathogenesis of chronic heart failure (CHF) complicated by sarcopenia. Evidence indicates that the prevalence of sarcopenia is significantly higher in CHF patients compared to their healthy counterparts. CHF can induce sarcopenia through multiple pathophysiological pathways, including malnutrition, hormonal alterations, autophagy dysregulation, oxidative stress, and apoptosis. Conversely, sarcopenia adversely affects disease progression and prognosis in CHF patients. Studies also confirm the notable clinical efficacy of Traditional Chinese Medicine (TCM) interventions—such as herbal compounds, massage, and Tai Chi—in managing sarcopenia. Given that sarcopenia often presents with subtle clinical signs, noticeable symptoms typically emerge only after substantial decline in muscle mass and function. Therefore, early screening for sarcopenia and prompt intervention in CHF patients are of paramount importance.</p>