Chagas cardiomyopathy is an infectious heart disease caused by infection of Trypanosoma cruzi. The pathological process of Chagas cardiomyopathy is divided into a self-limiting acute phase and an irreversible chronic phase, which is characterized by progressive myocardial fibrosis and neurogenic disorders. The diagnosis should be combined with epidemiological history, serological detection and multimodal imaging technology, and the treatment strategy includes pathogen control and complication management at the same time. At present, the clinical challenges of Chagas cardiomyopathy are focused on the high rate of missed diagnosis in non-epidemic areas and the lack of means to reverse chronic pathological reversal. Establishing a multidisciplinary diagnosis and treatment pathway based on serological screening and improving the hierarchical prevention and control system are the key to improve the global burden of Chagas cardiomyopathy. With the progress of research technology, the diagnosis and treatment strategies of Chagas cardiomyopathy are updated. In 2024, the first non-imported case of Chagas disease in China was reported. This article systematically discusses the clinical manifestations, diagnostic and treatment strategies, and the latest research progress of patients with Chagas cardiomyopathy, aiming to enhance the understanding of this disease among medical professionals in China and provide a reference for early detection, screening and standardized treatment.