Abstract: Elabela (also known as Apela, Ende, and Toddler) is a small signal peptide that activates the G protein coupled receptor Aplnr. It is a peptide hormone related to heart development and shares the same G protein coupled receptor (APJ) with Apelin. Elabela is considered an important regulator of cardiovascular homeostasis and may become a new therapeutic target for various cardiovascular diseases (CVD). At the physiological level, Elabela has angiogenesis and vasodilation effects, playing a crucial role in heart development. Elabela at the pathological level may be a novel diagnostic biomarker for various CVD. Elabela can have the effect of "anti hypertension, vascular protection and heart protection" after being used in the peripheral vein of the body. Elabela is the key treatment and diagnostic target of CVD, and has significant therapeutic effect on myocardial infarction, ischemia reperfusion injury, heart failure, atherosclerosis, hypertension, etc. This review aims to describe the physiological and pathological roles of Elabela in cardiovascular diseases.