Since the commencement of the artificial-heart program at the National Institutes of Health in 1964, many circulatory-support devices have been developed for short-term use in patients with end-stage heart failure. In the last decade, the interest on mechanical devices for ventricular assistance increased rapidly. As a result, significant advances in both the technology and clinical experience in the field of mechanical cardiac assist occurred over the last decade. In the current era, there is a wide variety of devices both available and in development. This article briefly reviews the evolving concepts and current systems on ventricular assist devices, as well as their role in today’s clinical practice.