Thyroid hormone has multiple effects on the cardiovascular system with important physiological consequences. Several genes that encode important regulatory and structural proteins in the heart have been shown to be thyroid hormone responsive. More notably, certain effects of thyroid hormone have been exploited therapeutically. Thyroid hormone is currently being evaluated as an inotrope and vasodilator in various clinical settings. Furthermore, new information has been recently accumulated on the role of thyroid hormone in the response of the heart to ischaemic stress. In fact, hyperthyroid and hypothyroid hearts display a phenotype of cardioprotection against ischaemia-reperfusion. Based on this evidence, the various actions of thyroid hormone on the cardiovascular system are highlighted in this review. Thyroid hormone, although limited by its adverse effects, might prove a suitable treatment for cardiovascular illnesses. Various thyroid hormone analogues are currently under development.