BACKGROUND: Mesenchymal stem cells have the functions of inhibiting inflammation and cell apoptosis, promoting tissue repair, angiogenesis, and immune regulation in ischemic heart disease. OBJECTIVE: To review the latest research progress of mesenchymal stem cells in myocardial ischemia-reperfusion injury to provide ideas and basis for their further research and clinical application. METHODS: PubMed, Wanfang, and CNKI databases were searched for relevant literature. The key words were “mesenchymal stem cell, MSCs, myocardial ischemia-reperfusion injury, MIRI, exosomes, inflammation, tissue repair, vascular regeneration” in Chinese and English, separately. Finally, 48 articles were included and further summarized. RESULTS AND CONCLUSION: Myocardial ischemia-reperfusion injury is a common pathophysiological process in clinical heart diseases. It is common in ischemic cardiomyopathy, cardiopulmonary bypass and heart transplantation. Its mechanisms include free radical damage, calcium ion overload, energy metabolism disorders, and inflammation and so on. In recent years, the treatment of mesenchymal stem cell transplantation has attracted attention. Its exosomal function, myocardial tissue repair, reduction of myocardial cell apoptosis and inhibition of inflammation provide a new idea for treatment of myocardial ischemiareperfusion injury. Adult mesenchymal stem cells are currently the first choice for the treatment of myocardial ischemia-reperfusion injury. Therefore, a better understanding of the mechanism of mesenchymal stem cells in myocardial ischemia-reperfusion injury and the latest research progress are extremely important for their in-depth research and clinical application. [ABSTRACT FROM AUTHOR]