Abstract: Mitochondrial homeostasis is closely related to its internal proteins. The mitochondrial inner translocase of the outer mitochondrial membrane (TOM) transport system plays a role for proteins to import into mitochondria. Studies have shown that subunit compositions of mitochondrial TOM system such as Tom70, Tom20 and Tom40 participate in the initiation and development of cardiovascular diseases, which provides us new ways to elucidate the pathogenesis and to develop therapies. This article focuses on the main findings of TOM system in cardiovascular diseases such as myocardial ischemia/reperfusion, hypertension, and heart failure.