Background <p>Heart failure (HF) is a major cardiovascular disease (CVD) with high morbidity and mortality. Research on the effect of electroacupuncture (EA) on the quality of life (QoL) of HF patients with reduced ejection fraction (HFrEF) remains limited. This study aims to determine the role of combining EA with conventional treatment in improving QoL for patients with HFrEF.</p> Methods <p>This single-blind, randomized controlled trial employed a pre- and post-test design at the Heart Failure and Acupuncture Clinics of UNS Hospital, Indonesia. Thirty-four participants participated, with random assignment to either an intervention or a control group. While the intervention group received pharmacological therapy combined with electroacupuncture, the control group received only pharmacological therapy. All pharmacological treatments were administered according to cardiologists' prescriptions in alignment with the 2021 European Society of Cardiology guidelines. In the intervention group, participants underwent 32 EA sessions conducted by a medical acupuncture specialist, delivered twice weekly for 30&#xa0;min per session. The primary outcomes were: (1) Change in Left Ventricular Ejection Fraction (LVEF); (2) Change in six-minute walk distance; and (3) Change in Kansas City Cardiomyopathy Questionnaire-23 (KCCQ-23) score, measured before and after the intervention period.</p> Results <p>The combination of pharmacological therapy and EA produced a significant increase in the mean of LVEF by 14.07 ± 5.67%, an improvement in mean 6MWD by 348.82 ± 61.23&#xa0;m, and an increase in mean KCCQ-23 score to 34.94 ± 5.99. Statistically significant differences were observed between the intervention and control groups for all measured outcomes (<i>p</i> &lt; 0.05).</p> Conclusions <p>The combination of conventional treatment and EA significantly improves quality of life in patients with HFrEF, representing a promising adjuvant therapy for heart failure.</p>