Abstract: Virtual reality (VR) technology, with its high degree of immersion, interactivity, and situational realism, is gradually being applied in the field of cardiopulmonary rehabilitation. However, during the cardiac postoperative rehabilitation process centered on exercise training, patients commonly experience kinesiophobia, which significantly restricts rehabilitation compliance and therapeutic efficacy. Although VR is regarded as a potential intervention tool for alleviating kinesiophobia, it may itself induce VR sickness, and the physical discomfort and avoidance behaviors triggered by the latter are inherently contradictory to the core principles of kinesiophobia intervention. This article systematically reviewed the current application status of VR technology in cardiopulmonary rehabilitation after cardiac surgery, focusing on analyzing the epidemiological characteristics of kinesiophobia, the theoretical mechanisms, content design, and clinical effects of VR intervention, and thoroughly exploring the contradictory relationship between VR sickness and kinesiophobia.