A series of new Al-TiO2-C-Y2O3 aluminum alloy grain refiners with different Y2O3 content was prepared by exothermic dispersion method using Al, TiO2, C, and Y2O3 powders as raw materials. Scanning electron microscopy (SEM), X-ray diffraction (XRD), and energy-dispersive X-ray spectroscopy (EDS) were used to investigate the effect of Y2O3 content on the structure of the Al-TiO2-C refining agent as well as the effect of the Al-TiO2-C-Y2O3 refining agent on the grain size and mechanical properties of an Al-5Cu alloy. The results showed that the Al-TiO2-C-Y2O3 refiner was composed of Al2O3, TiC, Al3Ti, Al5Y3O12, and Al20Ti2Y phases. The refiner with 4% Y2O3 content exhibited the best Al-5Cu alloy refining effect, achieving a grain size of about 210.5 µm. This was about 42% of the grain size of the original Al-5Cu alloy. Moreover, this refined Al-5Cu alloy exhibited the best mechanical properties, with a tensile strength and elongation of 173.13 MPa and 9.19% respectively. This was a 20.9% and 83.8% improvement compared with the original Al-5Cu alloy. However, with a further increase in Y2O3 content, an Al5Y3O12 phase was preferentially formed. This led to a decline in Al20Ti2Y phase content and a correspondingly weaker refinement effect.