Objective To evaluate the clinical effects of different doses of bisoprolol combined with fosinopril in the treatment of patients with dilated cardiomyopathy (DCM) complicated with ventricular arrhythmia. Methods Ninety patients with dilated cardiomyopathy complicated with ventricular arrhythmia were divided into two groups according to the digital table method. 45 patients in the control group were given bisoprolol (5mg) and fosinopril (10mg), and 45 patients in the observation group. Bisoprolol (10mg) and fosinopril (20mg) were administered. The clinical effects of the two groups were compared. Results The total effective rate of the observation group was 95.56%, which was significantly higher than that of the control group 82.22%, χ2 =4.0500, P<0.05). The BNP and CRP were significantly decreased after treatment (P<0.05). The BNP and CRP were observed in the observation group. Compared with the control group (P<0.05), LVEDV was significantly increased after treatment, while LVESV and LVEDD were significantly decreased (P<0.05), and the cardiac function indexes of the observation group were significantly better than the control group (P<0.05), the total number of ventricular premature beats, ventricular premature dysfunction, triple syndrome, and short ventricular tachycardia were significantly lower in the two groups (P<0.05), and the arrhythmia indexes in the observation group were significantly lower than those in the observation group. Control group (P<0.05). Conclusion High-dose bisoprolol combined with fosinopril in the treatment of DCM with ventricular arrhythmia has a significant clinical effect, can significantly reduce BNP, CRP indicators, and effectively improve cardiac function and arrhythmia status to improve prognosis.