Autophagy is a process in which damaged, modified or aging proteins and organelles are transported to the lysosome/vacuole for degradation. Autophagy is not only a widespread normal physiological process, but also a cell defense mechanism to adverse environment, involved in the pathological process of diseases. The normal level of autophagy can protect cells from environmental stimuli, however, continued excessive or insufficient autophagy could lead to disease. In the heart, myocardial autophagy plays a vital role to maintain myocardial function, but dysfunctional autophagy contributes to a diverse set of heart diseases, such as Danon disease. Multiple forms of cardiovascular stress can increase autophagic activity in cardiomyocytes, including chronic ischemia, reperfusion injury and Chronic hypoxia. The function of autophagy in these conditions is poorly understood: Does it serve a pro-survival function or contribute to disease pathogenesis, cell death, or both? Heart disease is the abnormal myocardia function when to produce a variety of pathological state. In the state of disease, cardiac autophagy degree will change, related to the occurrence and development of disease. As in Hypertrophic cardiomyopathy process, cell autophagy is reduced and aggravate myocardial hypertrophy. In heart failure process, autophagy increases can lead to cell death; And in myocardial infarction process, autophagy is enhanced and reduce the infarction area. But the real role of autophagy in the myocardium depending on the level of autophagic activation and the context in which it is induced. Currently, more and more people begin to pay close attention to the relationship between drugs and autophagy regulation, particularly on antitumor drugs and cardiovascular drugs. In addition, there are reports of estrogen receptor antagonists tamoxifen and vitamins also has a regulatory role for autophagy. To research of the relationship between autophagy and heart disease, and drugs on the regulation of autophagy will benefit for the occurrence and development of heart disease, and explore a new mechanism of drug treatment from the autophagy perspectives.