AIM: To investigate the association between social frailty and sarcopenia and their combined effect on clinical outcomes in outpatients with stage B heart failure (HF). METHODS: This post hoc analysis of the PAPRIKA-HF study included 331 patients aged ≥ 65 years with stage B HF. Patients were stratified into three groups based on social frailty and sarcopenia. The primary outcome was a 2-year composite of all-cause death, myocardial infarction, and HF hospitalization. RESULTS: Of 308 patients, 189 (61%) had social frailty. Sarcopenia prevalence was higher in patients with versus without social frailty (20.6% vs. 11.8%, p = 0.04). Event rates for the composite outcome differed across groups (absence of social frailty and sarcopenia: 1.9% vs. presence of social frailty or sarcopenia: 3.0% vs. presence of both: 33.3%; log-rank p < 0.001). In the multivariable Cox model, no significant difference existed between absence of social frailty and sarcopenia and presence of social frailty or sarcopenia (hazard ratio 2.44; 95% confidence interval 0.51-11.52; p = 0.26), while presence of both had higher risk compared with absence of both (hazard ratio 12.98; 95% confidence interval 2.46-68.50; p < 0.01). CONCLUSION: The coexistence of social frailty and sarcopenia is associated with adverse outcomes in outpatients with stage B HF. Early identification and multidisciplinary interventions for social frailty may help improve long-term prognosis.