Abstract: Endomyocardial biopsy (EMB) is a method of obtaining endomyocardial tissue from patients through invasive surgery, firstly used to monitor the rejection response after allogeneic heart transplantation. It has been developed into an important approach of diagnosing and evaluating a variety of cardiac diseases, including myocarditis, cardiomyopathy, drug-related cardiac toxicity, amyloidosis, storage disease and cardiac tumors. This article summarizes the development, clinical application, and issues to be noted of EMB.