General and patient-specific factors are involved in selecting the type of temporary mechanical support for patients in cardiogenic shock. The type of support largely depends on the shock’s etiology and the presence of counterindications to specific strategies. The transition to durable support requires a careful evaluation of the patient’s candidacy, the transition’s timing, and the level of support required. As device therapies continue to improve, a team-based approach of different cardiogenic shock specialists will lead to improved decision-making in this complex patient population.