Diagnosing infections in patients with implantable devices is challenging. Once the diagnosis is made, managing the infection requires complete device extraction in most of the patients, followed by appropriate antibiotic therapy and reimplantation in patients who meet the appropriate criteria. The use of an algorithm in determining appropriate steps of management results in low relapse rates. Healthcare professionals need to understand the indications for transvenous lead extractions. Specialized equipment, procedures, and techniques are required for the extractions. Among patients for whom lead extractions are indicated, the procedure has proven to be safe; however, patients with device-related endocarditis, especially in the setting of diabetes and renal failure, may have higher mortality rates with these procedures.