Cardiac injury is the second leading cause of death among trauma, with many types of injuries and complicated clinical manifestations. The direct severe cardiac trauma is highly lethal, 95% of patients occur pre-hospital death. With the improvement oftrauma treatment and the decrease of pre-hospital mortality, secondary myocardial injury after trauma has become more common, such as hemorrhagic shock, burns or multiple trauma injuries. Cardiac injury is a predictor of poor prognosis after multiple trauma and prolonged in-hospitalization. The mechanism of traumatic myocardial injury involves a series of unclear pathophysiological processes, such as damage associated molecular patterns, inflammation, complement activation, calcium dyshomeostasis, mitochondrial damage associated molecular patterns, etc., which lead to changes in the structure and function of cardiomyocytes.This review aims to summarize the research progress in the mechanism of traumatic cardiac injury, including primary and secondary myocardial injury, and to provide new ideas for clinical diagnosis, treatment and research.