Background: AHF is a critical event whose diagnosis must be prompt to end up in critical care management. Echocardiography is an essential diagnostic tool since it offers a diagnostic evaluation of cardiac function in patients with AHF minimally invasively. However, the clinical effects of this type of bedside echocardiography performed within the first twelve hours of admission are not well understood. Objective:The purpose of this study is to assess the impact of performing early bedside echocardiography in patients with AHF at the Hayatabad Medical Complex, Peshawar. Methods: The present prospective, non-interventional single-center study recruited patients from February 12, 2023 to May 7, 2024 (end of follow up visit) with AHF hospitalization regardless of cause. A transthoracic echocographic examination was done within 12 hours of admission to determine LVEF, valvular lesions, and fluid status. Morgagni’s outcomes assessed consisted of death in hospital, number of days actually in the CCU, and overall hospitalization days. Descriptive statistics were done using the SPSS software with an alpha level set at 0.05. Results: The first echocardiography resulted in treatment modification in 78% of the cases with alterations in diuretic doses (65%), introduction of inotropic agents (34%), and changes in volume administration (40%). The patients who received echocardiography at first instance had a relatively less duration of their stay in CCU: mean 4.2 days compared with the patients who did not receive echocardiography: 6.5 days and overall hospital stay: 7.8 days compared to 8.1 days. Also, the in-hospital mortality was also lower among the patients in the early echocardiography group (7.1 % compared to 15 %, p < 0.05). Conclusion: Here, early goal directed bedside focussedechocardiography is shown to enhance clinician’s decision making and individual patient outcome in AHF. These findings are an endorsement of early echocardiography as a routine component of assessment and management of AHF especially in low-resource settings to improve outcome and efficiency.