Prolonged interruption of coronary blood flow during heart surgery results in irreversible myocardial cell damage. Interventions such as thrombolysis, emergency percutaneous coronary angioplasty and coronary artery bypass surgery can restore blood flow to affected myocardial tissue. However, restoration of coronary blood flow following acute disruption is also accompanied by a further injurious phenomenon known as myocardial reperfusion injury. This article seeks to highlight the elements involved in this process and possible interventions to reduce its effects.