Background: The modification of N 6 -methyladenosine (m 6 A) is a dynamic and reversible course that might play a role in cardiovascular disease. However, the mechanisms of m 6 A modification in myocardial ischemia/reperfusion injury (MIRI) remain unclear., Methods: A mouse model of MIRI and a cell model of oxygen-glucose deprivation/reperfusion (OGD/R) HL-1 cells were employed. In an in vivo study, the total RNA m 6 A modification levels were determined by dot blot, and the key genes related to m 6 A modification were screened by real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot. In an in vitro study, the effects of AlkB homolog 5 (ALKBH5), an RNA demethylase, on cell proliferation, cell injury, and apoptosis were detected by the 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay, lactate dehydrogenase (LDH) and cardiac troponin-I (cTnI) levels, and flow cytometry. Besides, the m 6 A modification-changed and differentially expressed messenger RNA (mRNA) were determined by methylated RNA immunoprecipitation sequencing (MeRIP-seq) and RNA sequencing (RNA-seq) in ALKBH5 -overexpressed HL-1 cells. Finally, the mRNA levels of the promising targeted gene were examined by RT-qPCR and its m 6 A modification levels were examined by MeRIP-qPCR., Results: Our results showed that RNA m 6 A modification was involved in MIRI, in which ALKBH5 was downregulated. Functionally, by overexpressing or silencing ALKBH5 in experimental cells, we verified its protective properties on cell proliferation, cell injury, and apoptosis in the process of MIRI. Besides, we provided a mass of latent different mRNAs with m 6 A modification variation in ALKBH5-overexpressed HL-1 cells. Mechanistically, we further screened the most potential targeted mRNAs and suggested that triple functional domain (Trio) mRNA could be upregulated by ALKBH5 by reducing m 6 A level of Trio., Conclusions: This study demonstrated that the downregulated ALKBH5 might contribute to MIRI process by increasing the m 6 A modification of Trio mRNA and downregulating Trio., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-22-1289/coif). All authors report that this work was supported by the Maoming Science and Technology Program (No. 2020KJZX003); the High-Level Hospital Construction Research Project of Maoming People’s Hospital (No. zx2020016); National Natural Science Foundation of China (82100275 to Liu NB, 81900285 to Lei LM); and the Special Project of Dengfeng Program of Guangdong Provincial People’s Hospital (Nos. DFJH201812, KJ012019119, and KJ012019423). The authors have no other conflicts of interest to declare., (2022 Annals of Translational Medicine. All rights reserved.)