Background: Cardiorenal syndrome type 1 (CRS1) represents a critical medical condition characterized by the rapid deterioration of cardiac function leading to acute kidney injury (AKI), posing significant healthcare challenges. Understanding this complex syndrome is crucial for improving patient care. Material and Methods: We conducted a one-year cross-sectional observational study at the Department of Medicine, Indira Gandhi Medical College, Shimla, enrolling consecutive patients with acute heart failure (AHF). We defined CRS1 as the rapid worsening of cardiac function leading to AKI and employed the Framingham Criteria for HF diagnosis. AKI was assessed using the AKIN classification. Various clinical, laboratory, and echocardiographic parameters were examined, and statistical analysis was performed. Results: Among the 92 AHF patients, 15 (16.3%) met the criteria for CRS1, while 77 (83.7%) did not experience kidney injury (NCRS1). Shortness of breath was the most common presenting symptom (93.47%). Patients with CRS1 had significantly lower total leukocyte counts (TLC) but no significant differences in other hematological or biochemical parameters. Dilated cardiomyopathy (DCMP) was a significant predisposing factor for CRS1, while other factors, including smoking, diabetes, and hypertension, did not contribute significantly. Medications for AHF management showed no significant impact on CRS1 development. Patients with CRS1 had higher mortality rates and longer hospital stays, with DCMP and Rheumatic Heart Disease (RHD) being major contributors to mortality. Conclusion: CRS1 is more prevalent in females and the elderly, presenting with shortness of breath and often triggered by infections. Lower TLC and DCMP are associated with CRS1 development. Smoking, diabetes, and hypertension appear unrelated to CRS1. Medications for AHF management showed no significant influence. DCMP emerges as a key underlying etiology, with CRS1 patients experiencing higher mortality rates and extended hospital stays, highlighting the need for tailored management strategies.