There are several strategies for cell delivery in cardiac stem cell therapy. The cells can be delivered through coronary arteries, coronary veins, or peripheral veins. Alternatively, direct intramyocardial injection can be performed, using a surgical, transendocardial, or transvenous approach. In this article, we describe the most important conceptual aspects and the evidence for the use of these techniques, with emphasis on intramyocardial injections.