Introduction: Cardiomyopathy refers to a group of heart conditions characterized by abnormal structure of the myocardium. Dilated cardiomyopathy is the most common cause of heart failure in Sudan. It has different implications for the quality of life and the psychological status of patients. This study aims to assess the Psychological Impact and Quality of Life in Patients with Dilated Cardiomyopathy (DCM). Methods: A descriptive cross-sectional hospital-based study was conducted in the outpatient department of Alshaab teaching hospital. A sample of 107 patients diagnosed with dilated cardiomyopathy (DCM). Using self-administered questionnaires including socio-demographic data, the Hospital Anxiety and Depression Scale (HADS), and the WHOQOL-BREF. The study assessed the quality of life and psychological symptoms of participants using descriptive statistics, t-tests, and ANOVA to explore associations between clinical and sociodemographic factors and QoL outcomes. Results: The study showed that 23 (21.5%) patients had anxiety, and 19 (17.8%) patients had depression. Regarding the four domains related to quality of life, the physical health domain had the lowest mean score (56.15), indicating significant physical limitations, while the social domain scored highest (68.55), reflecting strong social support. Most participants were middle-aged, predominantly male, married, and residing in urban areas, with the majority reporting sufficient income. Higher NYHA class and lower LVEF were significantly associated with poorer physical and psychological quality of life, emphasizing the impact of heart failure severity. Employment and sufficient income were linked to better physical, psychological, and environmental scores. Mental health issues were prevalent, with 21.5% experiencing anxiety and 17.8% depression; these conditions significantly correlated with lower psychological and social QoL scores. Conclusion: Dilated cardiomyopathy affects patients’ psychological status and their quality of life. In this study, sociodemographic and clinical factors considerably influenced the participants' quality of life, underscoring the need for comprehensive management approaches addressing both medical and psychosocial aspects.