Objective：To investigate the impact of myocardial scarring and drug treatment response on the risk of ventricular arrhythmia in patients with nonischemic cardiomyopathy（NICM）. Methods：A retrospective analysis was conducted on 77 NICM patients with left ventricular ejection fraction（LVEF）≤35% who underwent cardiac magnetic resonance with late gadolinium enhancement（LGE）and received drug therapy at the First Affiliated Hospital of Nanjing Medical University. The changes in LVEF during the one -year follow - up period were collected. Kaplan - Meier curves and Log - rank tests were used for survival analysis，and multivariate analysis was performed using Cox proportional hazards regression. Results：The median follow -up time was 34（16-49） months. Changes in LVEF within one year after drug treatment were not related to LGE（P=0.379），but were negatively correlated with LGE burden，with a correlation coefficient of -0.295（95% CI：-0.487--0.076，P=0.009）. During follow-up，five patients experienced ventricular tachyarrhythmia（VTA）events. In survival analysis，VTA events were associated with LGE burden（P=0.005）but were not related to the presence of LGE ordrug treatment response（P=0.309，P=0.890）. In the multivariate Cox regression model，LGE burden was an independent risk factor of VTA events（HR=1.075，95% CI：1.002- 1.054，P=0.043）. The long - term composite endpoint of NICM patients was related to LGE burden and LVEF changes（P=0.040，P=0.025）. Conclusion：LGE burden is an independent risk factor for the occurrence of VTA events in NICM patients，and the occurrence of VTA events is not related to drug treatment response.