Abstract: AIM To investigate the effects of lower serum digoxin concentration (SDC, SDC<0.4 μg/L) on heart failure (HF) in Chinese population. METHODS Patients with HF took digoxin: 0.125-0.25 mg daily for three days and then 0.125 mg or 0.0625 mg once a day. All the patients were divided into three groups according to the SDC one week after taking digoxin: the low SDC group (SDC≤0.4 μg/L), middle SDC group (0.4 μg/L0.05). The arrhythmia rate in the high and middle SDC groups was significantly higher than that in the low SDC group (P<0.05). CONCLUSION Mortality rate and arrhythmia rate were higher in high SDC group compared with those in middle and low groups. The low SDC (0.31±0.08) μg/L is safer but as effective as middle and high SDC in HF in chinese population.