Cardiac mechanical complications are important determinants of prognosis in patients with myocardial infarction. Early reperfusion therapy after myocardial infarction can significantly reduce the incidence of mechanical complications, however, the mortality rate from mechanical complications does not decrease at the same time. Early diagnosis and treatment are key to improving the prognosis of mechanical complications. Mechanical complications most commonly occur within one week of myocardial infarction, and echocardiography is usually preferred to determine the type, location, and hemodynamic status of mechanical complications. Surgery is the decisive treatment, but the optimal timing is difficult to determine. Percutaneous treatment is emerging as an alternative treatment option for patients with high surgical risk, but there are still shortcomings in clinical practice. There are still many unresolved issues regarding strategies for selecting surgical and percutaneous treatment options for mechanical complications. This article summarizes the key clinical evidence for early diagnosis of mechanical complications and new strategies for the management of mechanical complications, and presents relevant statistical data on mechanical complications in our center to provide insights for clinical diagnosis and treatment.