Objective： To investigate the effects of sacubitril valsartan on ventricular remodeling, myocardial fibrosis and serum angiogenesis factors in patients with chronic ischemic heart failure (CIHF). Methods: A total of 200 patients with CIHF were randomly divided into observation group (100 cases) and control group (100 cases), which were treated with sacubitril valsartan and benazepril hydrochloride, respectively. The course of treatment in both groups was 6 months. Observe the curative effect of two groups. The cardiac function indexes [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD)], 6-minute walking distance (6MWT), Minnesota Living with Heart Failure Questionnaire (MLHFQ) score, myocardial fibrosis indexes [transforming growth factor-β1 (TGF-β1), soluble growth stimulating gene 2 protein (sST2)] and angiogenesis factors [vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1), angiotensin-1 (Ang 1)] were statistically analyzed before and after treatment in the two groups. Results: Comparing with the control group (71.13%), the observation group's total effective rate (86.46%) was higher (P<0.05). After treatment, the levels of NT-proBNP, LVEDD and MLHFQ score in the observation group were significantly lower comparing with the control group (P<0.05), while LVEF and 6MWT were significantly higher (P<0.05). After treatment, the serum levels of TGF-β1, sST2 and TIMP-1 in the observation group were significantly lower comparing with the control group (P<0.05), and the levels of VEGF, IGF-1 and Ang 1 were significantly higher (P<0.05). Conclusion: For CIHF, sacubitril valsartan can effectively regulate myocardial fibrosis indexes and angiogenesis factors, reverse ventricular remodeling, improve cardiac function and quality of life of patients, and has a good effect.