With the increasing aging of the population and the increasing number of patients with cardiovascular diseases, how to improve the damage of myocardial cells caused by acute myocardial infarction (AMI) and improve cardiac function after infarction has attracted widespread attention. Bone marrow mesenchymal stem cells (BMSCs) are easy to obtain and proliferate, naturally lack MHC class II antigens, and have the function of promoting angiogenesis. They have become ideal seed cells for improving the prognosis of myocardial infarction in tissue engineering. This review mainly summarizes the biological characteristics of BMSCs and the chemical, physical, co-culture, and gene transfection methods for inducing BMSCs to differentiate into cardiomyocyte-like cells in vitro, and discusses the protective effects of BMSCs and their exosomes on the heart in myocardial infarction.