Cardiovascular disorders remain the leading cause of death around the world. Heart transplan-tation is considered the only therapeutic choice defined as the gold standard strategy to manage end-stage heart failure. Nevertheless, the remaining POSTOPERATIVE COMPLICATIONS compromise both the survival rate and quality of life in heart transplantation recipients. The present study aimed to review the current findings concerning the main early COMPLICATIONS after heart trans-plantation, reliable predictors, diagnostic approaches, novel surgical techniques, and manage-ment strategies. The results demonstrated that significant advances in immunosuppressive phar-maceuticals, determining appropriate policies for donor acceptance, pre-and post-operative treatment/care, selection of the most compatible donor with the recipient, and the suggestion of novel diagnostic and surgical techniques over the past decade had dropped the mortality and morbidity rates early after transplantation. However, marrhythmia, atrial flutter, atrial fibrilla-tion, deep sternal wound infection along with other sites infections, low cardiac output syn-drome, acute graft dysfunction, pericardial effusion, constrictive pericarditis, and acute cellular rejection could be considered as the major early COMPLICATIONS following heart transplanta-tions that pivotally require further investigations.