Transthyretin cardiac amyloidosis (ATTR-CA) is a form of restrictive cardiomyopathy characterized by the abnormal deposition of transthyretin in the myocardial interstitium, presenting with clinical manifestations such as heart failure, atrial fibrillation, and cardiac conduction system disorders. The significant individual variability in the symptomatology of ATTR-CA patients poses considerable challenges for precise diagnosis. This study provides a review of biomarkers associated with ATTR-CA and highlights the TTR tetramer as a potential novel indicator. The amyloid deposition in ATTR-CA is closely related to the dissociation of TTR tetramers; however, the TTR tetramer is not included among the biomarkers currently used in clinical practice. Investigating the concentration, profile, and dissociation rate of TTR tetramers holds profound significance for the early detection and prognostic assessment of ATTR-CA. This article synthesizes the research on traditional biomarkers of ATTR-CA and emphasizes the potential application value of TTR tetramers in disease diagnosis and prognostic evaluation.