Abstract: Objective To observe the effectiveness and safety of levosimendan in treatment of left heart failure in elderly patients. Methods Totally 359 elderly patients with heart failure chosen from Chinese PLA General Hospital from January 2012 to June 2016 were divided into control group (n=148) with average age of (78.2±2.1) years and levosimendan group (n=211) with average age of (79.8±1.5) years. There was no significant difference in baseline data between the two groups. B type natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), fraction shortening (FS), 6 minute walk test (6MWT), changes of liver function, renal function and blood pressure, and difference between the rate of rehospitalization in patients of two groups were observed and compared. Results After 5 days, NT-proBNP in levosimendan group was significantly lower than that in the control group(3 995±522) pg/ml vs (6 972±517) pg/ml, P< 0.05. LVEF (36.48%±5.95% vs 27.21%±4.98%), FS (21.78%±5.22% vs 14.92%±5.09%), and 6MWT (317.59±45.64) m vs (154.37±40.59) m in levosimendan group were higher than those in control group (All P< 0.05). At 3 months after treatment, NT-proBNP in levosimendan group was significantly lower than that in control group (3 886±453) pg/ml vs (4 978±492) pg/ml, P< 0.05. LVEF (36.17%±5.17% vs 32.48%±4.89%), FS (20.99%±5.64% vs 17.84%±5.57%), and 6MWT (302.18±42.53) m vs (212.25±37.29) m in levosimendan group were higher than those in control group (All P< 0.05), and the rate of rehospitalization in levosimendan group was significantly lower than that in control group(8.53% vs 21.62%, P< 0.05). Conclusion Levosimendan can decrease the rehospitalization rate at 3 months after treatment, which is safe and effective for left heart failure in elderly patients.