Heart transplantation (HTP) is a life-saving therapy for select individuals with end-stage refractory heart failure. Despite improvements in quality of life and survival, HTP recipients' peak aerobic power (peak VO) remains up to 50% lower than age-matched healthy controls secondary to abnormal cardiovascular and skeletal muscle function. Currently, little is known regarding the effect of exercise training (ET) to improve peak VO post HTP. This brief review aims to summarise existing evidence regarding the role of ET on peak VO and its determinants, highlights the upper limits of endurance performance in highly trained HTP athletes, and identifies areas for future HTP exercise rehabilitation research.2