Emergency cardiac transplantation is a controversial subject in the present context of a lack of donor organs. There are few reports in the literature, which the authors review to suggest a practical approach which is clearly not consensual. The results in the literature report an extramortality of 10 to 30% if the indication of transplantation is that of an emergency. The poor results of emergency transplantation in the present day context of lack of donor organs have led the authors to abandon this indication. They only transplant patients in a stable condition without failure of organs other than the heart.