Background Although uric acid (UA) has been associated with an increased risk of cardiovascular events, it is unclear whether UA can provide greater prognostic information than N-terminal pro B-type natriuretic peptide (NT-ProBNP) in advanced heart failure with non-ischemic dilated cardiomyopathy (DCM). Method A total of 83 DCM patients (mean age 62 years, mean ejection fraction 27%) were evaluated with echocardiography. UA and NT-ProBNP were measured. Development of clinical events during follow-up was defined as the composite of cardiac death and admission for recurrent heart failure. Results During follow-up (mean 17 months), there were 15 cardiac events(1 death, 14 recurrent heart failure). In patients with cardiac events, UA and NT-ProBNP were significantly higher than in event-free patients. The receiver-operating characteristics curve for determining cut-off values of UA and NT-ProBNP for prognosis showed that the area under the curve for UA was greater (0.83, 95% CI 0.721-0.945) than that for NT-ProBNP (0.66, 95% CI 0.541-0.786). On multivariate Cox analysis, UA remained the only independent predictor for prognosis. Furthermore, UA���9 mg/dL rather than NT-ProBNP���3,500 pg/mL were associated with decreased cardiac event-free survival (log rank chi square=28.4 and 9.8; p<0.001, and p=0.002, respectively). Conclusion UA could be a prognostic predictor in patients with non-ischemic DCM and more informative than NT-ProBNP.