Abstract In current clinical electrophysiology practice, some patients receiving subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation may also require additional intracardiac electronic devices due to disease complexity or therapeutic needs. However, there remains a relative lack of domestic reports on the combined use of S-ICD with cardiac resynchronization therapy (CRT) and cardiac contractility modulation (CCM). This study retrospectively summarizes the clinical course and follow-up outcomes of two patients with advanced heart failure who underwent combined implantation of S-ICD with CRT and CCM. The aim was to evaluate the feasibility, safety, and preliminary effectiveness of a multi-device hybrid strategy in specific clinical scenarios. The results demonstrated favorable technical outcomes, device compatibility, and functional performance, with no significant electromagnetic interference or device conflict. Both patients showed improved cardiac function and clinical symptoms compared to baseline. This hybrid approach offers a viable alternative for patients ineligible for traditional transvenous ICD systems—such as those with limited venous access, high infection risk, or younger age—and expands the potential indications for S-ICD in the context of multi-device therapy. It also emphasizes the clinical value of integrating hybrid device implantation into individualized arrhythmia management strategies.