Heart ischemic preconditioning and postconditioning may have a protective effect against ischemia-reperfusion injury. Heart ischemic preconditioning can improve myocardial tolerance to ischemia, reduce myocardial infarct size, protect endothelial function, and is associated with significant reduction in ventricular arrhythmias, inotrope requirement and intensive care unit stay. Ischemic postconditioning may attenuate cardiomyocyte apoptosis and improve the recovery of left ventricular systolic function. This article focuses on the clinical application, main mechanism and influencing factors of heart ischemic preconditioning and postconditioning.