Cardiovascular disease is one of the leading causes of death worldwide, placing a huge burden on patients and healthcare systems. Cardiac shock wave (CSW) technology is a non-invasive treatment method. In recent years, some scholars have discovered that extracorporeal shock wave can improve cardiovascular ischemic lesions. This article reviews the latest progress in basic research and clinical application of cardiac shock wave technology in cardiovascular medicine and reviews its efficacy and potential mechanisms in different diseases. First, the principle of shock waves and their application potential in cardiovascular medicine are introduced. Then, from the aspects of basic research and clinical application, the mechanism and clinical efficacy of shock waves in cardiovascular diseases such as coronary heart disease, myocardial ischemia-reperfusion injury, atrial fibrillation, atherosclerosis, and coronary artery calcification are discussed, as well as its advantages and limitations. Animal experiments and clinical studies have found that low-energy extracorporeal shock waves can upregulate the expression of vascular endothelial growth factors, promote angiogenesis, promote nitric oxide production, increase local blood perfusion, significantly reduce angina symptoms, and improve left ventricular function and remodeling. Finally, the future development trend of shock wave technology is prospected. This review provides an introduction to the properties, biomechanical effects, treatment mechanisms of cardiovascular diseases, research status and development prospects of extracorporeal shock waves. Keywords: Cardiac shock Wave Therapy, Cardiovascular diseases, ESWT