Abstract: AIM:To explore the possible mechanism and to evaluate the clinical effects of sodium phosphocreatine in patients with dilated cardiomyopathy (DCM) with heart failure. METHODS: A cohort of 103 cases with DCM with heart failure was randomized into two groups. The control group was given ACEI or AEB agents, diuretics, β blockers (without contraindications), cardiac stimulant, and vasodilator agentbased anticardiac insufficiency treatment, whereas the therapy group was administered the same regimen plus sodium phosphocreatine. Changes in functional heart classifications and left ventricular diastolic function parameters and adverse drug reactions were observed before and after treatment. RESULTS: Clinical symptoms in both groups were alleviated after treatment, but clinical symptoms and signs such as shortness of breath, palpitations, and edema in the therapy group were better improved than in the control group (P<005). The decrease in probrain natriuretic peptide (BNP) levels and increase in left ventricular ejection scores in the therapy group were also more obvious (P<0.05). CONCLUSION: Sodium phosphocreatine can safely and effectively alleviate clinical symptoms and improve cardiac functions in patients with dilated cardiomyopathy with cardiac insufficiency.