OBJECTIVE： To observe the clinical efficacy of recombinant human brain natriuretic peptide （rhBNP） combined with levosimendan in acute decompensated heart failure （ADHF）. METHODS： In retrospective study， 120 cases diagnosed as ADHF were divided into observation group and control group according to treatment plan， with 60 cases in each group. The patients of control group received rhBNP on the basis of conventional treatment， intravenously pulsed with dose of 0.15 μg/kg firstly， then maintained dose of 0.007 5 μg/kg viacontinuous intravenous pumping for 24-72 h； On the basis of control group， treatment group received levosimendan with loading-dose of 12 μg/（kg·min）for 10 min， maintenance dose of 0.1 μg/（kg·min）via intravenous pump， for 24 h， adjusted according to clinical manifestations of patients. The vital signs， hemodynamic and UCG indexes， the rate of dyspnea recovery， plasma level of BNP， urine and the occurrence of ADR were recorded in 2 groups. RESULTS： The vital sign and hemodynamic indexes of control group had no significant change 1 h after treatment； the levels of HR， RR， SBP， MPAP and MPCWP in 2 groups after treatment were significantly lower than before， while the levels of SaO2 and CO were significantly higher than before， with statistical significance  （P＜0.05）. The levels of HR， RR， SBP， MPAP and MPCWP in observation group 1， 2， 4 h after treatment were significantly lower than in control group， while the levels of SaO2 and CO were significantly higher than control group， with statistical significance （P＜0.05）； there was no statistical significance in vital sign and hemodynamic indexes between 2 groups at other time points （P＞0.05）. 48 h after treatment， LVEF of 2 groups were increased while plasma levels of BNP were decreased， compared to before treatment； the improvement of observation group was more significant than control group， with statistical significance （P＜0.05）. And the urine volume of observation group were significantly higher than that of control group 24， 48 h after treatment， with statistical significance （P＜0.05）. There was no statistical significance in the rate of dyspnea recovery at different time points and the incidence of ADR after treatment between 2 groups （P＞0.05）. CONCLUSIONS： rhBNP combined with levosimendan could effectively improve vital sign， hemodynamic indexes， UCG indexes and dyspnea， and decrease the plasma level of BNP with good safety.