Cardiovascular disease (CVD) remains the leading cause of global mortality, prompting urgent efforts to explore novel therapeutic approaches. The remarkable success of mRNA technology brings new possibilities for CVD treatment, with numerous preclinical studies establishing proof-of-concept, and several have advanced into clinical trials. Leveraging cumulative experience in mRNA therapeutics, improved understanding of cardiovascular pathophysiology and developments in nanotechnology, genome editing and RNA synthetic biology, mRNA medicine presents promising opportunities for addressing CVDs. Here, we provide an overview of the advancements of mRNA-based biotechnologies for CVDs, including mRNA modifications, mRNA delivery platforms, mRNA-encoded genomic and epigenomic editing, and mRNA-based chimeric antigen receptors for immune cell engineering. We also summarize preclinical and clinical applications of mRNA medicine in various CVDs, including hypercholesterolemia, atherosclerosis, ischemic cardiac injury, cardiac fibrosis and cardiac amyloidosis. Finally, we discuss the challenges and highlight the future directions for bench-to-bedside translation of mRNA technology in the field of CVDs.