Tanshinones are lipophilic compounds derived from Salvia miltiorrhiza (Danshen) that has been widely used to treat coronary heart diseases in China. The cardioprotective actions of tanshinones have been extensively studied in various models of myocardial infarction, cardiac ischemia reperfusion injury, cardiac hypertrophy, atherosclerosis, hypoxia, and cardiomyopathy. This review outlines the recent development in understanding the molecular mechanisms and signaling pathways involved in the cardioprotective actions of tanshinones, in particular on mitochondrial apoptosis, calcium, nitric oxide, ROS, TNF-alpha, PKC, PI3K/Akt, IKK/NF-kappa B, and TGF-beta 1/Smad mechanisms, which highlights the potential of these compounds as therapeutic agents for treating cardiovascular diseases.