Abstract： Objective： To observe the clinical effect of Shenfu Qiangxin tang based on routine western medicine for severe heart failure in senile patients. Methods：A total of 52 cases of senile patients with severe heart failure were randomly divided into two groups，26 cases in each group. The control group was simply treated with routine western medicine，and the observation group was additionally treated with Shenfu Qiangxin tang based on the treatment of the control group. Both groups were treated for two courses，seven days being a course. The changes in the indexes of heart function including left ventricular end-systolic volume，left ventricular ejection fraction，cardiac stroke volume and cardiac output before and after treatment and the clinical effect in the two groups were observed. Results： The total effective rate was 88.46% in the observation group and 65.38% in the control group， the difference being significant(P＜0.05). After treatment， the left ventricular end-systolic volumes in the two groups were decreased when compared with those before treatment(P＜0.05)， and the left ventricular ejection fraction， cardiac stroke volume and cardiac output were increased(P＜0.05)； the improvement of the above indexes in the observation group was more significant than that in the control group(P＜0.05). Conclusion：The therapy of Shenfu Qiangxin tang combined with routine western medicine for severe heart failure in senile patients can effectively improve their heart function，whose curative effect is better than that of simple western medicine.