Abstract: Heart failure is the final stage of the development of various heart diseases, which seriously affects patients’ quality of life and brings a huge burden on social medical resources. It is a serious public health problem that needs to be solved urgently in China and the whole world. The decrease of myocardial contractility is the core mechanism of most heart failure and enhancing myocardial systolic function is of great importance in clinical treatment of heart failure, However, the application value and safety evaluation of traditional positive inotropic drugs have been controversial and the use of drugs is limited by mechanism related adverse reactions. Omecamtiv mecarbil, a newly studied cardiac myosin agonist, can effectively improve the cardiac function of patients with heart failure without the adverse reactions of traditional positive inotropic drugs by virtue of its unique mechanism. The drug has been extensively studied in patients with various types of heart failure and currently shows great potential in the treatment of heart failure with reduced ejection fraction.