Abstract: AIM: To explore the protective effect of trimetazidine dihydrochloride on acute viral myocarditis. METHODS: Eighty six patients with acute viral myocarditis were randomly divided into trimetazidine dihydrochloride metabolic drug treatment group (n=40) and usual routine treatment group (n=46). Patients in both groups were bedridden and were treated with antibiotics and hormones. Metabolic drug treatment group was administered trimetazidine dihydrochloride in addition to the synthetic treatment. Before and after treatment, venous blood was collected and tested including CK-MB, cTnI, ESR, hs-CRP and TNF-α. RESULTS: Levels of CK-MB, cTnI, hs-CRP and TNF-α of trimetazidine dihydrochloride treatment group were lower than levels of the routine treatment group (P<0.05), but no significant difference was observed between the ESR levels of the two groups. CONCLUSIONS: Trimetazidine dihydrochloride has demonstrated a protective effect on acute viral myocarditis.