Abstract: Allogeneic heart transplantation (HTx) is the primary treatment for patients with end-stage heart failure. Nevertheless, the long-term complication of cardiac allograft vasculopathy (CAV) after HTx is the main factor affecting the long-term survival of the recipients. Up to now, there is no effective methods to prevent and treat CAV. This article reviews the pathological manifestations of CAV, immunological factors of CAV and other risk factors of CAV, aiming to provide novel ideas and understanding for CAV research.