Abstract: Objective To explore efficacy and safety of L-carnitine in the treatment of chronic heart failure(CHF). Methods Totally 120 patients with CHF were randomly divided into control group(n=60)and observation group(n=60). The control group was treated with conventional anti-CHF drugs, while the observation group was treated with L-carnitine injection on the basis of the control group. Both groups were continuously treated for 14 days. The clinical efficacy, serum N-terminal pro-brain natriuretic peptide(NT-proBNP), galectin-3(Gal-3)and carbohydrate antigen 125(CA125)levels, left ventricular ejection fraction(LVEF), left ventricular internal diameter(LVID)and the maximum distance of 6-min walking test(6MWT)were compared between the two groups. Adverse reactions were recorded. Results The total effective rate of the observation group was significantly higher than that of the control group(91.67% vs. 71.67%, P<0.05). After treatment, levels of serum NT-proBNP, Gal-3 and CA125 and LVID in the observation group were significantly lower than those in the control group, while LVEF and 6MWT were significantly higher than the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment(21.67% in the observation group vs. 16.67% in the control group, P>0.05). Conclusion L-carnitine is effective in the treatment of CHF, which can effectively reduce the expression levels of serum NT-proBNP, Gal-3 and CA125, improve cardiac function, and it is safe in clinical use.