Since the pioneering work by Shinya Yamanaka's team on transcription factor reprogramming, which earned the Nobel Prize, induced pluripotent stem cells (iPSCs) have evolved with non-integrative reprogramming methods and chemical induction enabling exogenous gene-free generation. Their differentiated cardiomyocytes (iPSC-CMs) have been integrated into the Comprehensive in vitro Proarrhythmia Assay (CiPA) framework as a core alternative to animal models for cardiac safety assessment. Further advancing beyond two-dimensional limitations, cardiac organoids developed since 2021 through self-organization or microfluidic techniques now replicate three-dimensional structures with atrial/ventricular-like features. These models recapitulate cardiac developmental trajectories, simulate apoptosis and fibrosis in acute myocardial infarction, enable high-throughput screening of pro-proliferative compounds, and assess drug-induced cardiotoxicity. Currently, both platforms demonstrate multi-scenario applicability in disease modeling, drug development, and regenerative therapy, showcasing significant potential to replace traditional animal models and advance precision medicine.