Introduction: Cardiogenic Shock (CS) is a life-threatening condition characterized by low cardiac output, end-organ hypoperfusion and hypoxia. Inotropic pharmacological support is recommended to restore proper hemodynamic in these patients. Levosimendan is a calcium-sensitizer with unique features, since it exerts inotropic effects preventing myocardial oxygen consumption. In CS patients, its effects on in-hospital outcomes are not well known. Hypothesis: The aim of the study was to assess whether in CS patients, levosimendan administration on top of standard inotropic support could affect in-hospital outcomes. Methods: We retrospectively reviewed clinical data of 41 CS patients admitted to Cardiac Intensive Care Unit (CICU). We compared clinical course and outcomes, including length of stay (LOS), length of mechanical support (LMS) and in-hospital mortality, between CS patients receiving levosimendan on top of standard inotropic support (group 1) and not-receiving ones (group 2). Results: Overall, 41 patients [83% males, mean age 65.8 ± 13.01 years, mean left ventricular ejection fraction (LVEF) 26.75 ± 13.28%] with CS due to acute coronary syndrome (ACS) in 19 (46.34 %), acute decompensated heart failure (ADHF) in 21 (51.22 %) and myocarditis in 1 (2.44%) were included. Eleven (26.83%) patients received levosimendan on top of standard inotropic support (group 1) while 30 (73.17%) were not-receiving (group 2). Between the two groups, any difference was observed in baseline LVEF (p= 0.14), ACS and ADHF aetiologies (p=0.98, p=0.14). Mechanical support rate was similar between patients receiving and not receiving levosimedan (p=0.05), while LMS was higher in group 1 (p= 0.001). Both CICU and in-hospital LOS were longer in group 1 (p=0.0001, p= 0.004). Conversely, CICU and in-hospital mortality did not differ between the two groups (p=0.9, p=0.72). Conclusion: In CS patients, levosimendan administration on top of standard inotropic support did not improve in-hospital outcomes.