Although some advanced treatments of heart failure (HF) have experienced great development in recent decades, morbidity and mortality associated with HF have not improved significantly. Hydrogels have some unique advantages for the delivery and controlled release of bioactive molecules, drugs, and cells, which can directly affect the heart locally. Many studies have shown that hydrogels represent a new approach for the treatment of HF. In this review, we present a current perspective of hydrogel-based approaches for cardiac tissue engineering and myocardial regeneration in ischemia-induced HF, with an emphasis on functional studies, translation, and clinical advancements.