Background Myocardial/ischemia reperfusion injury (I/RI) is defined as myocardial injury caused by the restoration of coronary blood flow after an ischemic episode, which leads to severe myocyte metabolic derangements and ultrastructural impairment. The I/RI also triggers the activation of an inflammatory cascade evidenced by neutrophils accumulating and inflammatory mediators releasing. Thus the inflammatory response has been recognized as one of the most important mechanisms of I/ RI. It has been identified that reperfusion -induced inflammation and excessive production of cytokines can promote myocardial damage during ischemia and reperfusion. Thus modulating the inflammatory response at the onset of reperfusion may represent a potent therapeutic strategy to attenuate the myocardial I/RI. Objective Objects of this review are to evaluate the possible roles of the inflammatory response in mechanisms of myocardial I/RI. Content The effects of inflammatory mediators including inflammatory cells and cytokines in I/RI process are in detailed introduced. Trend The inflammatory response is exactly an important mechanism in IRI, but its effects in the I/RI process are not simple. Except damages caused by the inflammatory response, it can produce benefits. For improving cardioprotection, all treatments by regulating I/RI -induced inflammation should keep the balance of its two sides.