Abstract: Mediastinal radiotherapy is the main treatment method for breast cancer, esophageal cancer, lung cancer, and mediastinalinvolved lymphoma. Advancements in surgery, radiotherapy, and chemotherapy have led to an increasing number of cancer survivors; however, these patients may experience long-term side effects related to their cancer treatments. The long-term cardiovascular events caused by mediastinal radiotherapy have become important factors that threaten patients' long-term survival and quality of life. In this review, we describe the common clinical manifestations, diagnosis, and treatment options for patients with cardiac complications after mediastinal radiotherapy.