Objective: This study was designed to compare the effects of levosimendan and dobutamine on hemodynamics and clinical efficacy in patients with severe septic cardiomyopathy (left ventricular ejection fraction [LVEF] <35%).Design: A prospective, single-blind, randomized controlled study.Setting: In Baoding, China.Participants: Thirty patients with severe septic cardiomyopathy treated in the authors' hospital's Department of Critical Medicine from Septem-ber 2018 to September 2021 were enrolled in this study.Interventions: These patients were divided randomly into the levosimendan group and dobutamine group. The LVEF, cardiac index (CI), stroke volume index (SVI), systemic vascular resistance index, heart rate, norepinephrine dose, and lactate at the time of enrollment and the 24th hour were compared, along with myocardial injury markers on the third day, C-reactive protein, mechanical ventilation time, length of intensive care unit (ICU) stay, cost, and 28-day mortality. The primary outcome was 28-day mortality.Measurements and Main Results: At the 24th hour after treatment, CI, LVEF, SVI, and fluid volume were found to be higher in the levosimen-dan group than in the dobutamine group, whereas the dose of norepinephrine was lower in the former rather than the latter group. On the third day of treatment, cardiac troponin I in the levosimendan group was lower than that in the dobutamine group. Although the differences in 28-day mortality, ICU stay, and ICU treatment cost between the groups were not statistically significant, the ventilator application time of the levosi-mendan group was significantly shorter than that of the dobutamine group.Conclusions: Compared with dobutamine, levosimendan was more effective at improving cardiac function, reducing myocardial injury, and reducing mechanical ventilation time in patients with severe septic cardiomyopathy.(c) 2022 Elsevier Inc. All rights reserved.