Abstract: AIM To compare and analyze the clinical efficacy and safety of large doses of shenfu injection combined with levocarnitine in elderly patients with chronic heart failure. METHODS One hundred and forty-two patients from March 2014 to December 2015 were randomly divided into three groupsobservation group A(n=47), observation group B(n=48) and control group(n=47). In addition to conventional therapy and levocarnitine 2 g/day for all patients, patients in observation group A were given shenfu injection(50 ml/day) and patients in observation group B were given shenfu injection(100 ml/day). NYHA(New York Heart Association) Functional Classification, Lee's heart failure scores, left ventricular ejection fractions(LVEF), myocardial performance index(MPI), NT-proBNP, quality of life score and 6-min walk test(6 MWT) before and after treatment in the three groups were compared. RESULTS A significant improvement in the NYHA, Lee's heart failure scores, LVEF, MPI, NT-proBNP, quality of life score and 6 MWT was seen in observation group B compared with those in the other two groups(P<0.05). Treatment efficiency and total effective rate in observation group B were also higher than those in the other two groups(P<0.05). CONCLUSION Shenfu injection combined with levocarnitine shows a definite therapeutic effect in elderly patients with chronic heart failure and a large dose(100 ml/day) of shenfu injection combined with levocarnitine achieves obviously better curative effect than the lower dose(50 ml/day).