With the ageing process, structural and functional changes of myocardium occur, so the elderly become more sensible and vulnerable to hypoxic-ischemic damage than the young. Thus cardiovascular disease has already become the most deadly disease in the elderly, as well as a threat to their life quality. The mitochondrial permeability transition pore (mPTP) is a non-selective membrane channel, and the opening of mPTP leads to irreversible cell injury. Consequently, its opening regulation plays an important role in cardioprotection. Evidences indicated that the mPTP regulation of the aged myocardium is special. For example, cardioprotection drugs, which were effective to inhibit the opening of mPTP in the young, showed a decreased efficacy in the elderly. Moreover, it is noticed that the mPTP influences the aging process. Therefore, to improve diagnosis and treatment of cardiovascular disease in the elderly, further researches on the structure and function of mPTP in aged myocardium are essential.