Effective prevention and treatment of perioperative myocardial ischemia-reperfusion injury is an important problem to be solved urgently by multiple disciplines, and optimizing the energy metabolism of ischemic myocardium is the key to alleviate myocardial ischemia-reperfusion injury. It has been confirmed that adenosine monophosphate activated protein kinase (AMPK) is an important hub of energy metabolism, and can reduce ischemic myocardial injury by increasing glucose uptake, promoting autophagy and inhibiting apoptosis. This paper summarizes the protective effect and mechanism of AMPK in ischemic heart disease, and provides a theoretical basis for seeking the strategy of preventing and treating myocardial ischemia-reperfusion injury with AMPK as the target.