Ischemic cardiomyopathy receives significant attention due to its high mortality and morbidity worldwide. Numerous research has revealed that blood supply, ROS, inflammation, and thrombus play pivotal roles in the progression of myocardial damage and remodeling. The central approach for managing ischemic cardiomyopathy is the administration of therapeutic drugs against the pathological mechanism. Despite the development of abundant agents with therapeutic benefits, current therapeutic efficiency is insufficient for further clinical application due to its intrinsic limitations, including poor delivery efficiency and low retention capability. It is urged to seek alternative strategies to improve drug bioavailability and therapeutic index with high biocompatibility. With the emergence of nanotechnology, nanomedicine offer significant improvements to effectively deliver therapeutic molecules for treating ischemic cardiomyopathy. Recently, many biomaterials have been developed to enhance the efficiency of therapeutic drugs for the treatment of myocardial ischemic-related disease. This review summarizes the recent advances of nanomedicine in the treatment of ischemic cardiomyopathy, focusing on antithrombotic therapy, ROS-scavenging therapy, anti-inflammatory therapy, revascularization, and improving electrical conduction. We also discuss the potential limitations and further development of these therapeutic approaches to treat ischemic cardiomyopathy.