Introduction <p>Advancements in medical technology have revolutionised the management of end-stage heart failure in children with ventricular assist devices (VADs), improving survival but introducing a range of challenges including complex issues affecting nutritional progression and feeding behaviour. This scoping review aimed to synthesise available evidence on feeding behaviour in paediatric VAD patients, explore factors affecting feeding behaviour and nutritional progression, and identify key research priorities in this domain.</p> Methods <p>Robust methods from the Joanna Briggs Institute and PRISMAScR guidelines were followed. We searched six databases for evidence on children’s feeding behaviour and nutritional progression post-VAD insertion, in any healthcare setting. No restrictions were applied to study design, publication year, location, culture, or gender, but non-English data sources were excluded.</p> Results <p>Twenty-one data sources were included, with most (67%, <i>n</i> = 14) from the United States, and (58%, <i>n</i> = 12) originating from grey literature or retrospective cohort reviews. Five key themes emerged: failure to achieve feeding milestones, meeting normal growth and childhood development goals, disruptive environments to childhood nutrition and care, illness severity, and medical management’s effects on feeding and improving the VAD journey for children and their families.</p> Conclusion <p>This review identified themes and factors affecting nutritional progression and feeding behaviour in VAD children, highlighting research priorities like growth, developmental milestones, and support strategies. Future research should focus on prospective and longitudinal designs and collaborate with researchers on multiple outcomes to advance this emerging field.</p>