Objective: To observe the efficacy of furosemide injection combined with recombinant human B-type natriuretic peptide (rhBNP) in the treatment of acute heart failure (AHF) and its influence on cardiac function, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) levels. Methods: This study included 62 patients with AHF from January 2021 to January 2025. The above patients were evenly divided into two groups by random number table method, including conventional group and combined group, with 31 cases in each group. The conventional group was given conventional symptomatic treatment and furosemide injection (20 mg.time-1^, once.d^-1, intravenous bolus, treatment for 14 days), and the combined group was added with rhBNP (1.5 μg.kg-1 ^{as a loading dose} for intravenous bolus, followed by continuous intravenous pump at a rate of 0.0075-0.010 μg.kg-1^.min-1, treatment for 14 days) on the basis of the conventional group. After 14 days of treatment, the clinical efficacy in the two groups was observed. Before treatment and after 14 days of treatment, cardiac color Doppler ultrasound was used to evaluate the cardiac function [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and cardiac output (CO)] in the two groups. Serum NT-proBNP and cTnI were detected by enzyme-linked immunosorbent assay. Adverse reactions during treatment and major adverse cardiac events (MACE) within 90 days of follow-up were recorded in the two groups. Results: The total effective rate of treatment in combined group was significantly higher than that in conventional group (P<0.05). After 14 days of treatment, LVEF and CO in the two groups were significantly increased (P<0.05) while LVEDD and LVESD were significantly decreased (P<0.05), and the left ventricular function indexes in conventional group were better than those in combined group (P<0.05). After 14 days of treatment, the levels of NT-proBNP and cTnI in the two groups were decreased significantly (P<0.05), and the levels of serum biomarkers in combined group were lower than those in conventional group (P<0.05). There were no significant differences in the incidence rates of adverse drug reactions during treatment (14 days) and incidence rate of MACE within 90 days of follow-up between the two groups (P>0.05). Conclusion: Furosemide injection combined with rhBNP can effectively treat patients with AHF, and improve the cardiac function and myocardial injury, with good safety and high clinical application value.