Nowadays, cardiovascular diseases have become the No. 1 killer of human health. Developing high-resolution intracavitary imaging technology is conducive to the accurate diagnosis and treatment of cardiovascular diseases. Optical coherence tomography (OCT) has the advantages of non-contact, non-invasive, high-resolution, and fast imaging capabilities, which plays a crucial role in the guidance for the treatments of cardiovascular diseases. In this work, we first described the situation of increasing cases of percutaneous coronary intervention (PCI) in China in recent years, and then the development and application of OCT, endoscopic OCT, and cardiovascular OCT were introduced. We gave a detailed review of the progress of the cardiovascular OCT in academic research and commercial translation. The importance of cardiovascular OCT in clinical diagnosis of coronary plaques and the guidance of stents and prognosis were illustrated. In the end, this article provided the prospect outlook of cardiovascular OCT in future development, and the important research and application values of cardiovascular OCT were summarized.