Objective? To analyze the clinical efficacy and prognosis of sacubatrivalsartan compared with valsartan in patients with ejection fraction preserved heart failure（HFpEF）. Methods? A total of 60 patients with HFpEF admitted to Suzhou Ninth People's Hospital from December 2018 to December 2019 were selected as the study subjects，and the patients were divided into the control group and the observation group according to the random number table method，with 30 patients in each group. The control group was treated with valsartan based conventional treatment drugs for heart failure，and the observation group was treated with the treatment scheme based on sarkubatrovalsartan. The treatment effect and readmission of the two groups were compared after 6 months of follow-up. Results? Before treatment，there was no significant difference in N-terminal B-type brain natriuretic peptide（NT-proBNP）and 6-minute walking test distance between the two groups（t=0.754，0.532， P=0.454，0.597）；after treatment，the NT-proBNP（521.5±123.2）pg/mL of the observation group was lower than that of the control group（612.5±103.3）pg/mL，and the 6-minute walking test distance（550.3±52.4）m was longer than that of the control group（393.4±61.5）m，and the difference between the two groups was statistically significant（t=3.100，10.636，P=0.003，0.000）. There were 20 cases（66.67%）whose cardiac function grade improved by one level or above，which was higher than that of 10 cases（33.33%）in the control group，and the difference was statistically significant（χ2=6.67，P=0.001）；2 cases（6.67%）of the observation group were hospitalized again due to heart failure after treatment，which was lower than 7 cases（23.33%）of the control group（χ2=3.272，P=0.021）. Conclusion? The treatment of patients with preserved ejection fraction heart failure can achieve good results，which can improve the clinical symptoms and prognosis of patients. Therefore，the advantages of this treatment method are worthy of promotion and application.