A variety of cardiopulmonary conditions can arise in the setting of end-stage liver disease and have a substantial impact on clinical outcomes, including consideration for liver transplantation. Cardiopulmonary considerations in end-stage liver disease include heart failure, cirrhotic cardiomyopathy, coronary artery disease, arrhythmias, valvular heart disease, portopulmonary hypertension, hepatopulmonary syndrome, and hepatic hydrothorax. In this chapter, we will review the epidemiology, diagnosis, and management considerations of these cardiopulmonary conditions in patients with ESLD and in the context of liver transplantation. It is important to recognize these potential cardiopulmonary complications and implement evidence-based management strategies in order to better improve outcomes in ESLD.