Extracorporeal circulation (ECC) is a mature life support technology used for cardiac surgery, and its invention made it possible to cut open the heart and large blood vessels for direct vision surgery. Besides effects of the surgery, however, ECC-induced injuries on such important organs as the heart is the critical influencing factors of the patient′s prognosis. In case of serious injury, postoperative prognosis can be significantly affected. Over the decades, enhanced proactive measures have attenuated the extent of the myocardial injury, but decline in cardiac function exists because of the technical characteristics of ECC itself. This article reviews the pathological mechanism of ECC-induced myocardial injury and feasible measures to attenuate its extent.