Early repolarization has been considered a normal electrocardiographic variant for long time.Recent studies showed that the early repolarization patients had the increased risk of idiopathic ventricular fibrillation and sudden cardiac death.The mechanism of early repolarization is related to increase outward positive currents in repolarization phase,and the mechanism of arrhythmia is related to reentry and after depolarization.The advances of arrhythmia risk prediction,treatment,primary prevention,secondary prevention of early repolarization are reviewed in this paper.