Abstract：Objective To analyze the value of mechanical ventilation with Peep mechanical ventilation in the treatment of severe left ventricular heart failure complicated with cardiogenic shock.  Methods A total of 82 patients with severe left ventricular heart failure complicated with cardiogenic shock admitted to our hospital from January to August 2022 were selected and randomly divided into a control group and a study group using a random number table method, with 41 cases in each group. The two groups were treated with different methods, and the efficacy was compared.  Results The hemodynamic parameters and blood gas status in the study group were better than those in the control group, with statistically significant differences between the two groups（t＝32.030, 4.764, 94.164, 8.272, 38.623, 7.245, 5.475, all P＜0.05）. The effective treatment rate in the study group was higher than that in the control group, with a statistically significant difference between the two groups（χ2＝5.455, P＜0.05）.  Conclusion Mechanical ventilation with Peep mode has high value in treating severe left ventricular heart failure complicated with cardiogenic shock, improving hemodynamic parameters and blood gas status, shortening the recovery process, and achieving a high treatment efficacy rate.