We report a case undergoing heart transplantation due to gradual progression of heart failure four years and one month after dynamic cardiomyoplasty. This case reports a 61-year-old man who received drug therapy after being diagnosed as having idiopathic dilated cardiomyopathy, but his heart failure progressed to New York Heart Association (NYHA) class III-IV, and heart transplantation was thought to be indicated. However, dynamic cardiomyoplasty was performed because this patient rejected heart transplantation. An implantable cardioverter/defibrillator (ICD) was implanted for postoperative ventricular arrhythmia. After that, his symptoms rapidly improved, but his heart failure gradually worsened two years after surgery and heart transplantation was performed four years and one month after dynamic cardiomyoplasty. Since transplantation he has had an uneventful postoperative course without rejection or complications.