Cardiac efficiency is a hemodynamic variable derived from thermodynamics. It refers to the percentage of energy consumed to complete cardiac external work to total energy consumed by cardiac activity. It can be obtained from P-V loop curve. In recent years, cardiac efficiency can also be derived directly from minimally invasive devices. Studies have shown that it can change dynamically during hemodynamic management, and it is a good predictor for prognosis, which requires clinical attention. This article reviews the research progress of cardiac efficiency in hemodynamic management.