Fatty acid-binding proteins (FABPs) are a group of small cytoplasmic proteins, which belong to the calycin superfamily. FABP’s are abundantly expressed in tissues with active lipid metabolism and are thought to be involved in the intracellular transport of long-chain fatty acids. Several FABP isoforms exist including heart fatty acid-binding protein (H-FABP or FABP3), which has been isolated from a wide range of tissues including the heart and skeletal muscle. H-FABP is abundantly expressed in the cytosol of myocardiocytes and is rapidly released into the bloodstream following myocardial damage. As a result, H-FABP has been used in clinical practice as an early, highly sensitive marker of myocardial injury following acute myocardial infarction. Studies also suggest that H-FABP can be used as a reliable marker for heart failure and other cardiomyopathies including hypertrophic and dilated cardiomyopathy. In addition, H-FABP may be a predictive marker of cardiac injury in the early asymptomatic patients with metabolic syndrome.