Core Tip: Heart transplantation is the gold standard treatment of end-stage heart failure (HF). Heart transplantation patients present lower exercise capacity due to cardiac, vascular and skeletal muscle abnormalities. Exercise training improves exercise capacity, cardiac and vascular endothelial function in heart transplant recipients. Pre-rehabilitation regular aerobic or combined exercise is beneficial for patients with end-stage HF awaiting heart transplantation. All heart transplant recipients either hospitalized or after hospital discharge should be referred to a cardiac rehabilitation program. Individualized training still remains the most applicable approach despite the fact that high intensity interval training seems to have more benefits than moderate intensity continuous training.