Abstract: Treatment of myocardial infarction has remarkably advanced over the past 20 years. Cardiac stem cells cannot only differentiate into cardiomyocytes, smooth muscle cells and vascular endothelial cells, but also exert paracrine effects and regenerate injured heart tissue. Preclinical and clinical studies have shown that cardiac stem cells can attenuate cardiac remodeling, reduce the infarct area and improve cardiac functions. Many optimization strategies such as improving paracrine functions and combining genetic modifications and tissue engineering have been explored to further improve the therapeutic efficacy of cardiac stem cells and open a new paradigm in cardiology.