Heart transplant remain the definitive therapy for end-stage heart failure but is limited by the availability of suitable donors. Ventricular assist devices (VAD) are designed as mechanical pumps to supplement or replace the function of damaged ventricles and maintain appropriate blood flow in patients with end-stage heart failure. Survival rates continue to increase in patient with VAD but infection remains a major cause of morbidity and mortality in VAD patients. The authors describe the current concepts regarding definitions, diagnosis, microbiology and principles of management in VAD-associated infections. The authors have also summarised the prevention strategies for infections in VAD patients.