Catheter ablation is an effective treatment for ventricular tachycardia (VT) in structural heart disease to reduce VT recurrence and implantable cardioverter defibrillator shocks.Current guidelines recommend ablation in patients with recurrent or incessant VT. In patients with left ventricular assist device (LVAD), VTs may be well tolerated hemodynamically and catheter ablation has been performed rarely, until now. We present a case of successful VT ablation in a patient with LVAD and electrical storm. Effective ablation after a transseptal LV access was achieved using electroanatomic mapping and a substrate-based approach. On the basis of this case, we discuss the pros and cons of VT ablation in these patients.