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Although there have been great advances in the treatment of this condition that effectively increase survival, mortality remains unacceptably high, exceeding 40% at 5 years, which is worse than a large number of cancers. Furthermore, patients with advanced heart failure are a particular subgroup with higher hospitalizations and mortality, with a short-term survival that can be as low as 50% in the case of cardiogenic shock. Heart transplantation remains the gold standard treatment for these patients when other pharmacological and non-pharmacological interventions have failed, with a 1-year survival of approximately 90%. However, not all patients are suitable candidates for this procedure, and knowing the indications as well as the contraindications for heart transplantation is essential for appropriate patient selection. 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