Abstract: This article systematically reviewed the mechanisms and therapeutic breakthroughs of heart failure (HF) following acute myocardial infarction (AMI), with a particular focus on evaluating the cutting-edge advances in organoid models and gene therapy. HF is a common complication after AMI, significantly impacting patients' prognosis and quality of life. The pathogenesis of HF involves multi-pathway interactions, and various disease factors can exacerbate the progression of HF. Pharmacotherapy serves as the foundation, while device-based therapies such as cardiac resynchronization therapy (CRT) and implantable cardioverter-defibrillators (ICD) are also widely applied in clinical practice, offering more options for patients. For patients with end-stage HF, mechanical circulatory support and heart transplantation bring new hope. The emergence of emerging technologies, including gene therapy, human heart organoids, and organoid-on-a-chip, holds promise for further improving the prognosis of patients with HF after AMI.