Cell transplantation is becoming an important technique for treatment of heart failure. Preservation is an integral step in any procedure using cells. There are two primary modes of cell preservation at low temperature, hypothermic preservation at temperatures above freezing and cryogenic preservation at temperatures below freezing. Optimal preservation protocols require a fundamental understanding of the principles involved. This review briefly describes the basic mechanisms of damage during hypothermic and cryogenic preservation and the basic principles for developing optimal protocols for preservation of cells.