The essential role of cardiac troponin (cTn) in the diagnosis of acute myocardial infarction has led to the development of high-sensitivity assays, which are able to detect very small amounts of myocardial necrosis. However, although elevated blood levels of cTn indicate myocardial injury, they do not provide a causal explanation. The differential diagnosis of minor elevations of the cTn-level is broad and includes both acute and chronic cardiac and non-cardiac conditions. The purpose of this paper is to review common causes of elevated cTn-levels in daily clinical practice.