Abstract: Cardiovascular disease and cancer are two of the highest morbidity and mortality worldwide diseases. As one of the major treatments of malignant tumors, radiotherapy is widely used nowadays, especially in thoracic tumors. However, the heart cannot avoid to be radiated, which causes radiation-induced heart disease (RIHD). In this review, the pathological basis and biological mechanism of the radiation injury of the heart are described in detail, in order to explore the potential therapeutic targets of radiation injury.