Abstract: Despite recent advances in medical therapy, reperfusion strategies, implantable cardioverterdefibrillators and cardiac assistance devices, myocardial infarction (MI) remains a frequent cause of morbidity and mortality worldwide. Stem cell therapy has been introduced as a new treatment modality to regenerate lost cardiomyocytes. Cardiac stem cell (CSC) is one of the most hopeful types of stem cells to treat ischemic heart diseases. Although obvious improvement of left ventricular function has been reported in animal models, there are only moderate beneficial achievements clinically in myocardial regeneration. To date, strategies for improving effectiveness of cardiac stem cell therapy for myocardial infarction mainly include: 1) identification of the suitable CSCs; 2) gene engineering preconditioning of CSCs; and 3) development of methods to deliver CSCs into myocardium. Stem cell research and therapy will continue to provide novel approaches to diagnoses, therapies and tissue regeneration. In terms of the character of CSC and the mechanism of CSC therapy for MI, we review the recent developments of strategies to improve CSC therapy for MI and highlight the future goals and challenges that must be overcome.