Abstract Objective A large number of studies have provided strong statistical evidence that the Triglyceride-glucose (TYG) index is associated with the development and prognosis of cardiovascular disease. However, little is known about the predictive value of TYG index for ischemic cardiomyopathy (ICM). This study aimed to investigate the predictive value of TYG index in patients with ICM. Methods Hospitalized patients ICM in our Hospital from April 2014 to December 2017 were included in this study. Inclusion criteria: previous definite diagnosis of coronary atherosclerotic heart disease (coronary angiography found one or more vessels stenosis > 50%) and echocardiography showed LVEF < 45 percent. In addition, the TYG index was calculated as follows :LN[fasting triglycerides (mg /dl)× fasting blood glucose (mg /dl)x1/2]. The endpoint of the study was MACE events, including all-cause death, myocardial infarction, ischemia-induced revascularization and heart failure (HF) rehospitalization. Results A total of 688 patients were included in this study and followed up for 1 year. In the multivariate Cox proportional hazards model, TYG index (adjusted HR 2.33 [95% CI: 1.30-4.20], P<0.01) were associated with an increased risk of MACE events, and the area under the ROC curve (AUC) was 0.604 (95%CI: 0.528-0.680, p <0.05). A total of 197 ICM patients with previously diagnosed diabetes were screened for analysis. We found that TYG index (adjusted HR 6.63 [95% CI: 2.15-20.47], P<0.01), and the AUC was 0.691 (95%CI: 0.562-0.820, p<0.05). Conclusion TYG index can predict the poor prognosis of ICM patients, and the predictive value of TyG index for ICM patients with diabetes is more significant.