Cardiac amyloidosis (CA) is an infiltrative disease caused by the deposition of amyloid fibrils in the myocardium, leading to organ damage and dysfunction. The two main types of CA that affect the heart are amyloid light chain (AL) and amyloid transthyretin (ATTR) amyloidosis. Cardiac troponin (cTn) is the preferred biomarker for detecting myocardial injury and is frequently elevated in patients with CA, especially with high-sensitivity assays. Multiple mechanisms contribute to myocardial injury in CA, including the cytotoxic effects of amyloid precursors, interstitial amyloid infiltration, coronary microvascular dysfunction, and heart failure. cTn values have significant prognostic implications in both AL and ATTR amyloidosis. This review discusses the biology and measurement of cTn, the mechanisms of myocardial injury in CA, and the clinical application of cTn in managing both AL and ATTR amyloidosis. cTn is a diagnostic and prognostic aid in CA and helps monitor treatment response. High-sensitivity cTn assays provide increased sensitivity and precision, allowing for better risk stratification. The correlation between cTn values and hs-cTn values is good at higher levels but poor at low concentrations. cTn is a key biomarker in the diagnosis and management of CA, with significant prognostic value. The use of cTn in staging and monitoring treatment response in CA is well-established, and it plays a crucial role in the clinical management of patients with AL and ATTR amyloidosis. The field of cardiac biomarkers in CA continues to evolve, with new research and developments in the use of cTn and other biomarkers for diagnosis, prognosis, and treatment monitoring.Cardiac amyloidosis (CA) is an infiltrative disease caused by the deposition of amyloid fibrils in the myocardium, leading to organ damage and dysfunction. The two main types of CA that affect the heart are amyloid light chain (AL) and amyloid transthyretin (ATTR) amyloidosis. Cardiac troponin (cTn) is the preferred biomarker for detecting myocardial injury and is frequently elevated in patients with CA, especially with high-sensitivity assays. Multiple mechanisms contribute to myocardial injury in CA, including the cytotoxic effects of amyloid precursors, interstitial amyloid infiltration, coronary microvascular dysfunction, and heart failure. cTn values have significant prognostic implications in both AL and ATTR amyloidosis. This review discusses the biology and measurement of cTn, the mechanisms of myocardial injury in CA, and the clinical application of cTn in managing both AL and ATTR amyloidosis. cTn is a diagnostic and prognostic aid in CA and helps monitor treatment response. High-sensitivity cTn assays provide increased sensitivity and precision, allowing for better risk stratification. The correlation between cTn values and hs-cTn values is good at higher levels but poor at low concentrations. cTn is a key biomarker in the diagnosis and management of CA, with significant prognostic value. The use of cTn in staging and monitoring treatment response in CA is well-established, and it plays a crucial role in the clinical management of patients with AL and ATTR amyloidosis. The field of cardiac biomarkers in CA continues to evolve, with new research and developments in the use of cTn and other biomarkers for diagnosis, prognosis, and treatment monitoring.