Many studies have found that patients with supra-normal left ventricular ejection fraction (snLVEF) have long-term and short-term adverse cardiovascular outcomes, and gender differences. However, its pathophysiological mechanisms remain unclear. The incidence of snLVEF is widespread, accounting for 1/3 of known and suspected coronary artery diseases. Therefore, it is necessary to deepen the understanding of snLVEF in order to guide the clinical diagnosis and treatment. In this paper, the research status of snLVEF is reviewed in terms of the involved population, clinical prognosis, pathophysiological mechanisms, and also, the potential applications of imaging in snLVEF is briefly summarized.