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Abstract This Policy Resource and Education Paper (PREP) from the American College of Emergency Physicians (ACEP) discusses the use of high‐sensitivity cardiac troponin (hs‐cTn) in the emergency department setting. This brief review discusses types of hs‐cTn assays as well as the interpretation of hs‐cTn in the setting of various clinical factors such as renal dysfunction, sex, and the important distinction between myocardial injury versus myocardial infarction. In addition, the PREP provides one possible example of an algorithm for the use of a hs‐cTn assay in patients in whom the treating clinician is concerned about potential acute coronary syndrome.