Background:Despite improvements in medical treatment, ischemic heart disease (IHD) is still a major cause of death and disability worldwide. Among the most important diagnostic and therapeutic tools for IHD, cardiac magnetic resonance (CMR) offers detailed information about the structure, function, and viability of the heart muscle. Myocardial viability, function, and the presence of problems such microvascular blockage and ventricular thrombi can be better understood with the use of CMR imaging techniques like cine imaging, late gadolinium enhancement (LGE), and perfusion imaging. Myocardial strain analysis, including feature tracking, quantifies myocardial deformation and provides sensitive and specific markers of ischemia and dysfunction. Strain analysis has demonstrated prognostic value in predicting adverse cardiac events. Objective:This review aimed to summarize the current understanding of IHD pathophysiology, CMR techniques for IHD assessment, and the role of myocardial strain analysis in the evaluation of IHD. Methods: Using the following keywords: Ischemic heart disease, cardiac magnetic resonance, myocardial strain, feature tracking and myocardial infarction were all searched through Science Direct, Google Scholar, and PubMed. The writers also reviewed relevant literature references, although they only included the most recent or comprehensive study. Documents in languages other than English have been excluded due to lack of translation sources. Unpublished papers, oral presentations, conference abstracts, dissertations, and other works that were outside the scope of large-scale scientific studies were excluded. Conclusion:In order to properly assess and treat IHD, CMR is essential. The capacity of strain analysis to evaluate both local and systemic myocardial function provides important clues regarding the severity and prognosis of illness. Continued research and technological advancements will further enhance the clinical utility of CMR in optimizing the care of patients with IHD.