Endothelial system is a dynamic balance system to maintain the normal flow of blood, which is very important to maintain local homeostasis. It has been confirmed that endothelial cell integrity of the structure and function are important to the normal vessel wall permeability barrier, immune defense, anticoagulant，antithrombotic and anti-inflammatory response. Microvascular endothelial cell damage is closely related to myocardial no-reflow, which can significantly reduce the survival rate of patients with no-reflow, being clinical treatment challenges. Studies have shown ischemia-reperfusion results in structure and function of endothelial cell injury, which promote the development of no-reflow. The corresponding clinical intervention measures in a certain extent can repair the damage of endothelial cells and improve myocardial no-reflow to a certain extent. The latest endothelial cell injurious mechanism and clinical treatment application are reviewed here, in order to provide new theoretical basis of prevention of myocardial no-reflow for clinical treatment.