Heart Transplant & Left Ventricular Assist Devices (LVADs) represent advanced therapies for patients with end-stage heart failure who are unresponsive to conventional treatments. A heart transplant is the gold standard for eligible candidates, offering improved survival and quality of life. LVADs are mechanical pumps that support heart function by aiding the left ventricle in pumping blood to the body, used as a bridge to transplant or as destination therapy for non-transplant candidates. These interventions require comprehensive evaluation, surgical expertise, and lifelong follow-up to manage complications such as rejection, infection, and device malfunction. Innovations in immunosuppressive regimens, biocompatible materials, and remote monitoring technologies are improving outcomes. Ongoing research aims to enhance graft longevity, expand donor criteria, and optimize LVAD design, transforming the future of advanced heart failure care.