Apoptosis is an evolutionarily conserved suicide process. It plays critical roles in the development and homeostasis of cardiac tissues. However, excessively stimulated apoptotic activity induced by a myriad of deleterious stimuli can result in too much cardiomyocyte death. The regenerative potential of the adult cardiomyocytes is limited. The cardiomyocyte loss cannot be compensated by efficient cell proliferation. It inevitably leads to various heart diseases. Therefore, the inhibition of cardiomyocyte apoptosis is an important therapeutic strategy for heart diseases. Chinese materia medica (CMM) has more than 2000 years of history and provides effective adjuvant therapeutic strategies for heart disease at the clinical level. The mechanisms underlying the beneficial effects of CMM on heart diseases have been a major focus of recent research. Interestingly, it has been demonstrated that CMM can up-regulate the levels of anti-apoptotic proteins and down-regulate the levels of pro-apoptotic proteins to inhibit apoptotic activity, thereby suppressing cardiomyocyte apoptosis in response to harmful stimuli. The inhibitory effects of CMM on apoptotic activity are mediated by the transduction of intracellular signaling. In this review, we summarize and discuss current findings on the roles and mechanisms of CMM in cardiomyocyte apoptosis.