The Abiomed Impella(®) 2.5 is a micro-axial flow, catheter-based left ventricular assist system (LVAS). Designed for percutaneous insertion into the femoral artery and positioned across the aortic valve, the Impella(®) is capable of pumping 2.5 liters of blood per minute from the patient's left ventricle into the ascending aorta. Since United States Federal Food and Drug Administration clearance in June of 2008, use of the Impella(®) 2.5 has grown rapidly. We operate at the center of a "hub-and-spoke" regional referral network that facilitates the transfer of patients in cardiogenic shock to our facility for definitive care. Based on our recent experience of transporting patients supported on the Impella(®) 2.5 system, we review system operation, pump position, monitoring, and recommendations for providing safe and efficient transport.