Objective To explore the diagnostic value of myocardial contrast echocardiography (MCE) combined with cardiac magnetic resonance imaging (MRI) in patients with ischemic cardiomyopathy (ICM). Methods A total of 80 patients with ICM treated in the hospital were enrolled as observation group between October 2020 and October 2021, while 80 healthy volunteers undergoing physical examination during the same period were enrolled as control group according to the principle of orientation matching. Both groups underwent MCE and cardiac MRI examination. The difference in left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), ratio of early blood flow peak velocity to end-diastolic peak blood flow velocity (E/A), late diastolic motion velocity (Am) and early mitral valve diastolic blood flow peak velocity (E) between the two groups were compared. The diagnostic efficiency of MCE, cardiac MRI and combined detection for ICM was evaluated by ROC curves. Results MCE showed that LVESV in observation group was higher than that in control group, while LVEF, E/A, Am and E were lower than those in control group (P<0.05). The examination of cardiac MRI showed that LVESV in observation group was higher than that in control group, while LVEF,E/A, Am and E were lower than those in control group (P<0.05). There were significant differences in Am between MCE and cardiac MRI in observation group (P<0.05). The results of ROC curves analysis showed that AUC, sensitivity and specificity of MCE and cardiac MRI in the diagnosis of abnormal myocardial function were (0.781, 0.762), (85.00%, 71.25%) and (75.00%, 77.50%), respectively. AUC, sensitivity and specificity of combined detection were 0.819, 93.75% and 70.00%, higher than those of single index (P<0.05). Conclusion MCE combined with cardiac MRI has good diagnostic value in ICM patients, with certain reference for clinical diagnosis.