Hokin and Hokin were the first to demonstrate that tissue inositol phospholipid (phosphoinositide, PI) turnover was increased by hormone treatment. Twenty years later, Michell published a seminal review in which he suggested a relationship between stimulated inositol phospholipid metabolism and Ca2+ mobilization. The biochemical link between these two events was subsequently identified by Berridge and colleagues as inositol trisphosphate (InsP3), a Ca2+-mobilizing ligand that is formed by the breakdown of phosphatidylinositol bisphosphate (PIP2). The other product of inositol phospholipid hydrolysis, diacylglycerol, activates a Ca2+-sensitive phospholipid-dependent protein kinase, protein kinase C, which has been considered as a potential regulator of cardiac ion channels, inotropic state, and gene expression. This review summarizes our current state of knowledge concerning the formation of phosphoinositide-generated second messengers in cardiac cells and their potential role in mediating functional responses in the myocardium.