Apoptosis is defined as a genetically programmed cell death. Apoptotic cell death plays an important role both in heart development and cardiac disease. This review deals with the key features of this process. The modification of possible interactions between extrinsic and intrinsic factors affecting the cell during apoptotic process may be of major interest in preventing the progression of cardiovascular disease. Current issues on the pathogenetic role of apoptosis in heart disease and how these knowledge can be applied in clinical usage is also evaluated in this review.