Objective To explore the short-term and long-term efficacy of sacubitril/valsartan in patients with dilated cardiomyopathy accompanied by heart failure. Methods: 118 patients with dilated cardiomyopathy accompanied by heart failure admitted to our hospital from January 2022 to March 2024 were selected as the research subjects. The patients were divided into the conventional group and the combined group by the random number table method, with 59 cases in each group. The conventional group was treated with conventional clinical drugs. The combined group was treated with sacubitril/valsartan on the basis of the control group. The short-term clinical efficacy, adverse reactions, cardiac functions [left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), and left ventricular ejection fraction (LVEF)], and long-term efficacy [Minnesota Heart Failure Quality of Life Scale (MLHFQ) and 6-minute walking distance (6-MWD)] of the two groups were analyzed and compared. Result: After 3 months of treatment, the total effective rate of the combined group was significantly higher than that of the conventional group (P < 0.05). There was no significant difference in the adverse reaction rate between the two groups (P > 0.05). After 3 months of treatment, LVEDD and LVESD in both groups decreased significantly compared with those before treatment, and LVEF increased significantly compared with those before treatment. Moreover, the change amplitudes of LVEDD, LVESD and LVEF in the combined group were significantly greater than those in the conventional group (P < 0.05). After a 6-month follow-up, the 6-MWD of both groups was significantly increased compared with that before treatment, and the MLHFQ scores were significantly decreased compared with those before treatment. Moreover, the variation amplitudes of 6-MWD and MLHFQ scores in the combined group were significantly greater than those in the conventional group (P < 0.05). Conclusion: Treating patients with dilated cardiomyopathy accompanied by heart failure with sacubitril/valsartan can enhance their short-term and long-term therapeutic effects, improve cardiac function, and has a relatively high treatment safety.