Objective This study aimed to explore the predictive factors for left ventricular ejection fraction (LVEF) improvement after revascularization. Methods This real-world study examined 993 patients with ischemic HFrEF who had received revascularization (PCI or CABG), had survived at least 90 days and had undergone an echocardiography review. Based on the change in the LVEF, we divided the patients into two groups. Result We obtained 454 patients with >= 10% improvement and 539 with <10% improvement or deterioration. By Cox regression analysis, we obtained five independent factors for LVEF improvement, including female (P = 0.018, OR 0.726, 95% CI 0.557-0.947), prior MI (P = 0.000, OR 0.590, 95% CI 0.476-0.732), LVEF (P = 0.008, OR 0.967, 95% CI 0.943-0.991), digoxin (P = 0.027, OR 0.708, 95% CI 0.521-0.961), loop diuretic (P = 0.000, OR 1.515, 95% CI 1.208-1.901), and triple-vessel disease (P = 0.000, OR 1.462, 95% CI 1.192-1.792). By multivariate generalized estimation, we obtained seven factors associated with the degree of improvement, namely, low LVEF, short LVESD, short LVEDD, no prior MI, no hyperuricemia, clopidogrel use and triple-vessel disease. Conclusions The method of revascularization (PCI vs CABG) had no effect on LVEF improvement. Patients with severely impaired baseline LVEFs, triple-vessel disease, or no history of MI tended to exhibit marked LVEF improvement (>= 10%) after revascularization. In addition, LVESD, LVEDD, hyperuricemia, clopidogrel use and loop diuretic affected the degree of improvement.