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OBJECTIVE To observe the effect of levosimendan on the clinical efficacy of patients with acute decompensated heart failure (ADHF). METHODS Collected 124 patients with acute decompensated heart failure who were admitted to the cardiology department of our hospital from October 2019 to October 2020. According to the random number table method, they were divided into control group and levosimendan group. The control group was given traditional anti-heart failure treatment, and the levosimendan group was added with levosimendan injection on the basis of the control group. The clinical efficacy indicators, functional indicators, incidence of adverse reactions, mortality during hospitalization, rehospitalization rates and combined endpoint events within 3 months of follow-up were compared before and after treatment. RESULT The results of clinical efficacy comparison showed that the number of significant effective number in the controlgroup was less than that of the levosimendan group, and there was no difference in the number of effective, ineffective and total effective groups; the improvement of dyspnea after treatment in the levosimendan group was better than that of the control group; cardiac color Doppler ultrasound LVEF in control group is higher than Levosimendan group, LVEDV and LVESV are lower than control group; The BNP control group was higher than the levosimendan group. There was no significant difference in renal function between the two groups.The urine output of the control group was less than that of the levosimendan group.There was no statistically significant difference in adverse reactions, rehospitalization rates within 3 months, and mortality between the two groups of patients, and the combined endpoint event (death or rehospitalization) was significantly lower than that of the control group. CONCLUSION Levosimendan in the treatment of patients with acute decompensated heart failure can achieve significant clinical effects, and effectively improve the patient's hemodynamic indicators and increase renal perfusion.With the deepening of the aging of the population in China, the incidence of decompensated heart failure in the elderly population is higher, which seriously affects the normal life. Acute decompensated heart failure (ADHF), a kind of heart disease, is a clinical syndrome characterized by dyspnea with sudden onset and rapid peak based on abnormal heart function (11. It is typical of the late stage of heart disease, usually on the basis of chronic heart failure. The disease is complex and difficult to treat. In addition, the mortality rate of patients is high [2], which endangers the health of patients and threatens their life safety, and is the key disease of current clinical attention. At present, drug therapy is mainly adopted in the clinical treatment to stabilize the hemodynamic level of patients. Clinical practice shows that it is not significantthe to adopt conventional symptomatic treatment effect/which demands a new effective treatment scheme. Levosimendan .a new type of positive inotropic drug, -can increase myocardial contractility and has significant effects in improving heart failure which will reduce mortality, improve the incidence of arrhythmia and bring hope to patients [3]. This study took 124 cases admitted to our hospital as the research object, and analyzed the therapeutic effect of levosimendan. The report are as follows.