Mesenchymal stem cells (MSCs) belong to the family of pluripotent stem cells, which have an obvious multi-directional differentiation potential and can regulate the immune response of the organism by influencing immune cell subsets, thus they have excellent prospects for application in inflammation, immune diseases, and organ transplantation. Numerous studies have shown that MSCs are a promising strategy for the treatment of cardiovascular disease by modulating immune cell subsets and coordinating local and systemic innate and adaptive immune responses, thereby enabling the formation of a stable inflammatory microenvironment in damaged cardiac tissues. In this review, we summarize the mechanisms by which MSCs interact with immune cells and exert immunomodulatory effects, and explain the therapeutic effects of this mechanism in the treatment of cardiovascular diseases. A feasibility analysis is provided for the application of MSCs in cardiovascular diseases.