Dilated cardiomyopathy (DCM) is a common myocardial disease characterized by ventricular dilatation and progressive depression of myocardial contractile function. Disturbances in both humoral and cellular immunity have been described among these patients. A number of antibodies against various cardiac cell proteins have been identified in DCM. Recent data indicate that cardiac antibodies play an active role in the pathogenesis of DCM, and may contribute to cardiac dysfunction of DCM patients. Therefore, removal of cardiac autoantibodies by immunoadsorption may induce hemodynamic improvement in DCM patients. Various studies with a limited number of patients indicate that immunoadsorption improves left ventricular function in DCM.