Elevated cardiac troponin levels often lead to a diagnosis of acute coronary syndrome (ACS). However, this finding may occur also in other conditions, both nonischemic and noncardiovascular, leading to an incorrect diagnosis of ACS and, sometimes, invasive tests. We describe various cardiovascular diseases other than ACS (heart failure, pulmonary embolism, etc.) and noncardiovascular diseases (renal failure, etc.) that may cause elevated troponin levels and give possible explanations and prognostic relevance for this rise.