Aim: To observe the effect of β2-adrenergic agonist clenbuterol on ischemia/ reperfusion (I/R) injury in isolated rat hearts and hydrogen peroxide (H2O2)-in-duced cardiomyocyte apoptosis. Methods: Isolated rat hearts were subjected to 30 min global ischemia and 60 min repeffusion on a Langendorff apparatus. Car-diac function was evaluated by heart rate, left ventricular end-diastolic pressure (LVEDP), left ventricular systolic pressure, maximal rise rate of left ventricular pressure (+dp/dtmax), and the coronary effluent (CF). Lactate dehydrogenase (LDH) in the coronary effluent, malondialdehyde (MDA), superoxide dismutase (SOD), and Ca2+-ATPase activity in the cardiac tissue were measured using commercial kits. The apoptotic cardiomyocyte was detected by terminal deoxynucleotidyl transferase-mediated digoxigenin-dUTP nick-end labeling (TUNEL) assay. Bax/ Bcl-2 mRNA levels and the expression of caspase-3 were detected by RT-PCR and immunoblotting, respectively. Cultured newbo rat cardiomyocytes were pre-incubated with clenbuterol, and oxidative stress injury was induced by H2O2. Cell viability and cardiomyocyte apoptosis were evaluated by flow cytometry (FCM). Results: In the isolated rat hearts after I/R injury, clenbuterol significantly im-proved diastolic function (LVEDP and CF) and Ca2+-ATPase activity. Treatment with clenbuterol increased SOD activity and decreased the MDA level and LDH release compared with the I/R group (P<0.05). Moreover, clenbuterol decreased apoptosis, which was associated with a reduction in TUNEL-positive cells, Bax/ Bcl-2 mRNA, and caspase-3 expres-sion. In H2O2-induced cardiomyocyte injury, clenbuterol increased cell viability and attenuated cardiomyocyte apoptosis. Pre-treatment with ICI 118551 (selective β2-adrenergic antagonist) decreased these ef-fects compared with the clenbuterol-treated group (P<0.05). Conclusion: Clenbuterol ameliorated ventricular diastolic function by enhaning Ca2+-ATPase activity and reduced oxidative stress and cardiac myocyte apoptosis in an experi-mental rat model of myocardium I/R. It decreased cardiomyocyte apoptosis in-duced by H2O2 in vitro. It plays a key role in the cardiac protection against myo-cardium I/R injury.