〔Abstract〕 Objective To explore the clinical efficacy of amiodarone in the treatment of coronary heart disease arrhythmia in the elderly. Methods 118 elderly patients with coronary heart disease and arrhythmia admitted to Maoming City People's Hospital from June 2018 to December 2019 were selected and grouped by random number table, with 59 cases in the control group and 59 cases in the observation group. The control group was treated with conventional drugs, and the observation group was treated with amiodarone. The clinical efficacy, adverse reactions, the duration of abnormal electrocardiogram, the duration of symptoms, and the length of hospital stay were observed. Results The total effective rate of treatment for patients in the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05); the incidence of adverse reactions in the observation group was significantly lower than that of the control group, and the difference was statistically significant (P < 0.05); The duration of abnormal ECG, duration of symptoms, and hospital stay in the observation group were significantly shorter than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion Amiodarone has a good effect in the treatment of arrhythmia of coronary heart disease in the elderly.