Cardiac comorbidities in patients with cirrhosis are common yet frequently under-recognised. Cirrhotic cardiomyopathy, a subclinical state of cardiac dysfunction, is emerging as a critical contributor to major adverse cardiac events in this patient population, as well as liver events such as hepatorenal syndrome. The increasing prevalence of patients with metabolic dysfunction-associated steatotic liver disease and concomitant coronary artery disease also poses significant management challenges for these patients. This review focuses on the considerable burden of cardiac disease in patients with cirrhosis, most notably in those undergoing assessment for liver transplantation. Our findings highlight the importance of early detection and the use of appropriate management strategies to enhance post-transplant cardiovascular outcomes.