OBJECTIVE: To observe the efficacy and safety of atorvastatin calcium combined with metoprolol in the treatment of chronic congestive heart failure (CHF). METHODS: 207 CHF patients were randomly divided into control group (102 cases) and observation group (105 cases). Control group received cardiac, diuretic, vasodilating and oxygen inhalation, Metoprolol tartrate tablet with initial dose of 6.25 mg, 2-3 times a day, then increased 6.25-12.5 mg based on the improvement, 2-3 times a day. Observation group additionally received 80 mg Atorvastatin tablet, twice a day. The treatment course for both groups was 16 w. Clinical efficacy, cardiac functions [left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), mitral early diastolic and late diastolic peak flow velocity ratio (E/A)], blood lipids [lipoprotein (a) Lp(a), triglyceride (TG), total cholesterol (TC)] levels before and after treatment, and the incidence of adverse reactions in 2 groups were observed. RESULTS: The total effective rate in observation group was significantly higher than control group, the difference was statistically significant (P<0.05). Before treatment, there were no significant differences in cardiac functions and blood lipids in 2 groups (P>0.05). After treatment, the LVEF and E/A in 2 groups were significantly higher than before, and observation group was higher than control group, LVESD, Lp(a), TG and TC were significantly lower than before, and observation group was lower than control group, the differences were statistically significant (P<0.05). And there was no significant difference in the incidence of adverse reactions (P>0.05). CONCLUSIONS: Based on conventional treatment, the efficacy of atorvastatin calcium combined with metoprolol is superior to metoprolol in the treatment of CHF, with better safety.