The 5-year risk of death following onset of heart failure (HF) is about 50%. While previous studies have shown beneficial effects of light-to-moderate alcohol consumption and risk of cardiovascular diseases and mortality, it is unclear whether moderate alcohol consumption is associated with a lower risk of death in HF subjects. We investigated whether alcohol consumption and type of alcohol preference are associated with risk of total mortality in 449 US male physicians with prevalent HF. Alcohol consumption was assessed via food frequency questionnaire, and mortality was ascertained via annual follow up questionnaires and adjudicated by an Endpoint Committee. The mean age of subjects was 75.7 ± 8.2 years with an average follow up of 7 years. We found evidence of a J-shaped relation between alcohol consumption and mortality [HR (95% CI): 1.00 (ref), 0.85 (0.61–1.20), 0.60 (0.40–0.88), and 0.71 (0.42–1.21), for alcohol intake of none, <1/day, 1–2/day, and 3+/day respectively (p for quadratic trend: 0.058)]. There was no relation between beverage preference (beer, wine, or liquor) and mortality. In conclusion, our data showed a J-shaped association between alcohol intake and mortality in patients with HF.