Heart failure affects more than 5 million people in the United States. The treatments of this disease include medical therapy, heart transplantation, and the implantation of ventricular assist devices. These devices are used in patients who are no longer responsive to conservative medical treatment, who are not candidates for a heart transplantation (destination therapy), who are awaiting a heart transplantation (bridge to transplantation), and who have acute heart failure and whose myocardial function is expected to return to normal (bridge to recovery). Although this therapy improves the mortality and quality of life among patients with heart failure, the devices also carry risk of multiple complications. This article discusses the acute and long-term complications of ventricular assist devices.