Myocardial infarction (MI) is one of the leading causes of heart failure and death worldwide. While conventional treatments have limitations in promoting myocardial repair and regeneration, hydrogel, as a multifunctional biomaterial, shows great potential in MI treatment due to its unique physicochemical properties and biocompatibility. This paper reviews the multifunctional applications of hydrogels in MI therapeutics, including drug delivery (miRNAs, exosomes, ), electrical conduction, immunomodulation, detection, tissue engineering, and microfluidic functions. In terms of drug delivery, hydrogels are able to precisely deliver drugs, stem cells and exosomes to improve the microenvironment of the infarcted area through their controlled release properties. In the field of electrical conduction, hydrogels are used as scaffolding materials that mimic the mechanical and electrical properties of myocardial tissues. The role of hydrogels in immunomodulation has also attracted much attention. In addition, the application of hydrogels in biosensing and detection functions provides new strategies for real-time monitoring of MI. In summary, hydrogels have demonstrated multifunctional advantages in MI therapy, but their clinical applications still face challenges, such as the long-term biocompatibility of the materials and the feasibility of large-scale production. Future research should focus on optimizing the design of hydrogels for more precise treatment and wider applications.