【Abstract】 Objective To observe the effect of ginsenoside and isoflurane combined pretreatment on myocardial ischemia-reperfusion injury in rats, and to explore the mechanism of TLR 4 / NF k B signaling pathway. Methods 50 male SD rats were divided into sham operation group, perfusion injury group, isoflurane pretreatment group, ginsenoside group and isoflurane + ginsenoside pretreatment group. After corresponding operation, the rat were killed, the contents of IL-6 and TNF-a in blood were detected, the infarct area was calculated, the myocardial histopathology was observed, and the expression characteristics of NF-kB and TLR4 Protein and mRNA were detected. Results The myocardial cells in the sham operation group were arranged in a fibrous pattern, and the cells in the ischemia-reperfusion injury group were obviously disordered. Compared with sham operation group, NF-k B, TLR4, IL-6 and TNF-a in myocardial ischemia-reperfusion injury group increased significantly (P＜O.05). Compared with myocardial ischemia-reperfusion injury group, the expression of myocardial infarction area, IL-6, TNF-a, NF KB and TLR4 in isoflurane group, ginsenoside group and isoflurane + ginsenoside group decreased significantly (P＜O.05). In addition, the expression of myocardial infarction area, serum IL-6, serum TNF-a, myocardial NF-kB and TLR4 in isoflurane + ginsenoside group were lower than those in isoflurane group and ginsenoside group (PV0. 05). Conclusion The combined pretreatment of ginsenoside and isoflurane can effectively improve the cardiac pathology and myocardial infarction area.The mechanism may be related to reduce the expression of TLR4 and NF-kB protein and mRNA in myocardium, and improve the inflammatory sponse.