Donation after circulatory death (DCD) has emerged as a viable strategy to expand the donor pool for heart transplantation. Initially limited by technical, ethical, and logistical challenges, advancements in preservation and evaluation methods—such as normothermic regional perfusion (NRP) and ex situ machine perfusion—have renewed interest in this approach. Historically, DCD heart transplantation lagged behind liver and kidney transplantation due to the concerns about ischemia-reperfusion injury. However, recent innovations have shown that the outcomes of DCD heart transplantation are comparable to those of donation after brain death. This manuscript reviews the evolution of DCD heart transplantation, highlighting key breakthroughs in donor heart preservation, assessment techniques, and the implementation of NRP and ex situ machine perfusion systems. Despite ongoing clinical challenges, including ethical considerations surrounding NRP protocols and the economic burden of ex-situ machine perfusion systems, DCD heart transplantation has proven effective in reducing transplant waiting times and improving access for patients with end-stage heart failure.