After reperfusion, the condition of the ischemic myocardium aggravates, which causes the irreversible change of myocardium ultrastructure, resulting in the further damage of cardiac function, metabolism and electrophysiology; It is called myocardial ischemia reperfusion injury (MIRI). Cell apoptosis is closely related to the development of most cardiovascular diseases. There is cell apoptosis in many heart diseases, such as heart failure, myocardial infarction, arrhythmia, cardiomyopathy and so on. Cell poptosis plays an important role in the progress of MIRI. ATP-sensitive potassium channel (KATP) participates in a variety of activity and function regulation of cells, and it has the role of dilating blood vessels and myocardial protection, so increasingly becoming a hot spot of concern. However, the detailed mechanism of KATP regulating cell apoptosis is not yet clear. This review summarizes the recent progress in the role and possible mechanisms of KATP mediated MIRI.