Background: Ocular infections associated with organ transplantation are well documented following renal and liver transplantation; however, few studies have reported ocular infections following heart transplant. Methods: We retrospectively studied patients who underwent heart transplantation in the Mayo Clinic Cardiac Transplant Program from January 1st 1988 through June 30th 2006. Results: We report the frequency and type of ocular infections among 313 heart transplant recipients. There were eight patients (2.5%) diagnosed with ocular infections including three cases of ophthalmic zoster, one case of cytomegalovirus retinitis, one case of Aspergillus fumigatus endophthalmitis, one case of Haemophilus influenzae conjunctivitis, one case of blepharitis, and one case of preseptal orbital cellulitis. Conclusions: Ocular infections are rare after heart transplantation and usually present within the first year post-transplantation. The majority can be regarded as opportunistic infections which may be indicative of infections at other body sites. Ocular infections after heart transplantation may be associated with significant morbidity and visual loss if not promptly diagnosed. © 2009 John Wiley & Sons A/S.