Abstract: Heart failure is the terminal stage of various cardiovascular diseases, clinically characterized by high prevalence and high mortality. Based on the spatiotemporal view of The yellow emperor’s inner classic and the “three-dimensional network system” of collateral disease, this paper systematically explores the evolution law of spatiotemporal pathogenesis and clinical syndrome differentiation and treatment ideas of heart failure, and holds that its onset has distinct dual attributes of time and space. In the temporal dimension, the disease presents a dynamic pathogenesis evolution, with the circadian rhythm as the pivot of the growth and decline of yin and yang, the four-season rhythm as the foundation of the vicissitude of yang qi, and the disease course rhythm as the guideline of the progression of disease condition. In the spatial dimension, it follows the hierarchical lesion characteristics that Sunluo stasis is the initial link, large collaterals obstruction is the core of progression, and water retention in the whole collateral network is the terminal outcome. On this basis, the core therapeutic principle of “spatio-temporal unblocking of collaterals” is established. Medication is administered in accordance with temporal rhythm and spatial structure to exert the comprehensive effect of regulating qi, blood and body fluid in the heart collaterals, aiming to provide theoretical basis and new clinical ideas for TCM syndrome differentiation and staging as well as full-cycle targeted intervention of heart failure.