Cardiac amyloidosis (CA) is an infiltrative disease characterized by the deposition of amyloid fibrils in the myocardium, primarily affecting two types: amyloid light chain (AL) and amyloid transthyretin (ATTR) amyloidosis. Cardiac troponin (cTn) is a biomarker of choice for detecting myocardial injury and is frequently elevated in patients with CA, particularly with high-sensitivity assays. Multiple mechanisms contribute to myocardial injury in CA, including cytotoxic effects of amyloid precursors, interstitial amyloid fibril infiltration, coronary microvascular dysfunction, non-amyloid-related coronary artery disease, diastolic dysfunction, and heart failure. The prognostic and diagnostic significance of cTn values is significant in both AL and ATTR amyloidosis. This review discusses the biology and measurement methods of cTn, potential mechanisms of myocardial injury in CA, and the clinical application of cTn in managing both AL and ATTR amyloidosis. High-sensitivity cTn assays have improved analytical performance, allowing for earlier detection of myocardial injury and better risk stratification. The use of cTn in CA management includes diagnostic algorithms, prognostic assessment, and monitoring response to treatment. Future research directions include further validation of cTn assays in CA, exploration of novel biomarkers, and development of improved staging systems.Cardiac amyloidosis (CA) is an infiltrative disease characterized by the deposition of amyloid fibrils in the myocardium, primarily affecting two types: amyloid light chain (AL) and amyloid transthyretin (ATTR) amyloidosis. Cardiac troponin (cTn) is a biomarker of choice for detecting myocardial injury and is frequently elevated in patients with CA, particularly with high-sensitivity assays. Multiple mechanisms contribute to myocardial injury in CA, including cytotoxic effects of amyloid precursors, interstitial amyloid fibril infiltration, coronary microvascular dysfunction, non-amyloid-related coronary artery disease, diastolic dysfunction, and heart failure. The prognostic and diagnostic significance of cTn values is significant in both AL and ATTR amyloidosis. This review discusses the biology and measurement methods of cTn, potential mechanisms of myocardial injury in CA, and the clinical application of cTn in managing both AL and ATTR amyloidosis. High-sensitivity cTn assays have improved analytical performance, allowing for earlier detection of myocardial injury and better risk stratification. The use of cTn in CA management includes diagnostic algorithms, prognostic assessment, and monitoring response to treatment. Future research directions include further validation of cTn assays in CA, exploration of novel biomarkers, and development of improved staging systems.