In this study, high temperature design and creep-fatigue damage evaluation of a decay heat exchanger (DHX) in the decay heat removal systems of a sodium-cooled fast reactor (SFR) have been performed. Detail design and 3D finite element analysis have been conducted for the DHXs to be installed in active and passive decay heat removal systems in Korean Generation IV SFR, and the DHX installed in the STELLA-1(Sodium integral effect test loop for safety simulation and assessment) at KAERI (Korea Atomic Energy Research Institute). Evaluations of creep-fatigue damage based on full 3D finite element analyses were conducted for the two Mod.9Cr-1Mo steel heat exchangers according to the elevated temperature design codes of ASME Section III Subsection NH and RCC-MR code. Code comparisons were made based on the creep-fatigue damage evaluation and issues on conservatisms of the design codes were discussed.