Abstract: It is known that apoptosis is an actively mediated programmed cell death. However, in recent years, non-apoptotic programmed cell death has been recognized. Necrosis has traditionally been regarded as passive and unregulated and the newly discovered necroptosis is a death receptor mediated caspase-independent cell death. A large number of studies showed that necroptosis is an active process which is regulated by intracellular signal factors and myocardial cell necrosis and apoptosis are important pathological processes of heart diseases. This review discusses the role of necroptosis in myocardial ischemia and heart failure, its relationship with apoptotic pathways and new therapeutic opportunities the regulated necroptosis presents.