Abstract: The best treatment strategy for ischemic heart disease (IHD) is to restore myocardial perfusion as early as possible, but reperfusion can lead to injury of the ischemic myocardium, i.e. myocardial ischemia-reperfusion (MI/R) injury. MI/R injury can enlarge the myocardial infarct area, affect hematologic reconstitution and seriously affect patient prognosis. Therefore, the use of pharmacological intervention and prevention of MI/R injury is a major need and goal of clinical salvage in IHD. The active ingredients of traditional Chinese medicine provide new medication strategies and pathways for the prevention and treatment of MI/R injury. Preparations containing ginseng are widely used in the treatment of cardiovascular diseases and ginsenosides are the active ingredients of ginseng. The mechanism of action of ginsenosides on cardiovascular diseases has yet to be elucidated and it is therefore necessary to explore the cardioprotective effects of ginsenosides in depth. This paper reviews the mechanisms associated with ginsenosides in the treatment of MI/R injury, providing a theoretical basis and translational possibilities for the clinical application of ginsenosides.