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Left ventricular assist devices (LVADs) have become a standard treatment modality for the management of end-stage heart failure, either as a bridge to cardiac transplantation or as destination therapy. Infection is a frequent complication in up to one-third of LVAD recipients. Although the epidemiology of LVAD infections has been well-described, strategies for prevention, diagnosis, and management of these infectious complications remain controversial and vary among institutions. The goals of this review are to provide the infectious diseases practitioner with a brief introduction to the general anatomy and physiology of an LVAD, pre-implantation infectious disease management guidance, and an understanding of the epidemiology and pathophysiology of LVAD infections. We address methods for the diagnosis and characterization of these infections and suggest medical and surgical approaches for management