Objective：To observe the clinical effect of Tanreqing injection combined with vancomycin for senile patients with heart failure complicated with pulmonary infection， and its effect on the expression of brain natriuretic peptide(BNP)， choline esterase(ChE)，and inflammatory factors in serum. Methods：A total of 104 cases of senile patients with heart failure complicated with pulmonary infection were selected， and were divided into the combination group and the control group according to the random number table method，52 cases in each group. The control group was given routine treatment and vancomycin， and the combination group was additionally given Tanreqing injection based on the treatment of the control group. Both groups were treated for one week. The clinical effect， the improvement time of symptoms， and the hospitalization time were compared between the groups. Before and after treatment，left ventricle ejection fraction(LVEF)， left ventricular end- systolic diameter(LVESD)，and left ventricular end- diastolic diameter(LVEDD) were compared between the two groups. Before and after treatment，levels of BNP，ChE，interleukin- 6(IL- 6)，tumor necrosis factor- α(TNF- α)， procalcitonin(PCT)， CD4 + ， CD8 + ， and CD4 +/CD8 + in serum were compared between the two groups. Results： After treatment，the effective rate was 94.23% in the combination group，significantly higher than that of 76.92% in the control group(P＜0.05). After treatment，the recovery time of body temperature，the disappearance time of gasping，moist rale in the lung，and cough，as well as the hospitalization time in the combination group were shorter than those in the control group(P＜0.05). When compared with those in the same group before treatment，levels of ChE，CD4+，and CD4+/CD8+ in serum，as well as levels of LVEF in the two groups were increased after treatment(P＜0.05)；levels of BNP，IL-6，TNF-α， PCT，and CD8+ in serum，as well as levels of LVESD and LVEDD in the two groups were decreased after treatment(P＜0.05). After treatment，levels of ChE，CD4 +，and CD4 +/CD8 + in serum，as well as level of LVEF in the combination group were higher than those in the control group(P＜0.05)；levels of BNP，IL-6，TNF-α，PCT，and CD8+ in serum，as well as levels of LVESD and LVEDD were lower than those in the control group(P＜0.05). Conclusion：In the treatment of senile patients with heart failure complicated with pulmonary infection， the therapy of Tanreqing injection combined with vancomycin can promote relief from symptoms， shorten the hospitalization time， improve the heart function and immune function， and relieve inflammatory responses，with significant curative effect.