Abstract: Objective To observe the clinical efficacy of rhBNP in the treatment of senile patients with refractory heart failure. Methods Total 94 patients with refractory heart failure in the second hospital of Bengbu from March, 2015 to February, 2017 were enrolled into this study. The patients were randomly divided into observation group and control group according to random number table, with 47 cases in each group. The control group was adopted routine treatment for heart failure, such as dopamine or digitalis, angiotensin inhibitors, furosemide diuretics. The observation group was given rhBNP based on the control group. The clinical symptoms, signs and cardiac function were observed before and after the treatment. The levels of serum of NT-proBNP, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDd), heart rate and adverse drug reactions were observed in both groups before and after the treatment for 7 days. Results After the treatment, the effective rate of ameliorating refractory heart failure was significantly higher in the observation group than that in the control group (P<0.01), and the difference was statistically significant. Compared with the control group, the NT-proNBP value of the observation group was significantly decreased, the EF was significantly increased and the heart rate was significantly decreased, and the difference was statistically significant (P<0.05). There was no significant difference in adverse reaction rate between the two groups (P>0.05). Conclusion RhBNP treatment of elderly patients with refractory heart failure can significantly improve the clinical symptoms and cardiac function of patients with heart failure, significantly reduce the level of serum NT-proNBP, increase LVEF, reduce heart rate, while no significant adverse drug reaction. The curative effect of rhBNP is good on senile refractory heart failure, and it can significantly improve the hemodynamic parameters without obvious significant adverse reactions.