Background Social support may be associated with HF self-care; however, the mechanisms are not well understood. We examine the association between perceived support and self-care behaviors and whether self-care confidence mediates these relationships. Methods Cross-sectional survey of HF patients seen in outpatient clinic settings. Our outcome (HF self-care maintenance and self-care management) and mediator (HF self-care confidence) variables were assessed using the Self-Care of Heart Failure Index. Perceived emotional/informational support assessed using the Medical Outcomes Study social support survey. We performed regression analyses to examine associations between perceived support and HF self-care behaviors. Mediation analysis was performed according to Baron & Kenny method. Results We surveyed 150 HF patients (mean age 61 yrs; 51% female; 43% African Americans). More emotional/informational support was associated with better self-care maintenance (β=0.13, p=0.04). More emotional/information support was associated with better self-care management (β= 0.23, p=0.04) in unadjusted, but not adjusted analysis (β= 0.20, p=0.10). Self-care confidence mediates the association between perceived support and self-care maintenance (percent change in β coefficient was 32%) and management (percent change in β coefficient was 20%). Conclusion Perceived emotional/informational support is associated with better self-care maintenance and possibly better self-care management. Greater self-care confidence is one mediating mechanism.