Radiation-induced heart disease (RIHD) is a severe complication in patients with thoracic cancer undergoing radiotherapy, with important impacts on long-term survival among cancer survivors. There is an urgent need to investigate the pathogenesis of RIHD and to develop effective therapeutic agents, and the establishment of high-quality RIHD animal models is pivotal to addressing these issues. This review summarizes the critical factors to consider in establishing RIHD animal models, including species selection, radiation type, dosage, fractionation, and target fields, and modeling timeline, along with the evaluation method and success criteria. We also consider the potential pathogenic mechanisms underlying RIHD, including DNA damage, oxidative stress, inflammatory responses, mitochondrial dysfunction, renin-angiotensin-aldosterone system activation, and myocardial fibrosis, as well as their interrelationships. These insights provide a comprehensive reference framework for constructing RIHD animal models and advancing mechanistic investigations into this condition.