Infections at the exit site of the percutaneous cable (driveline) in patients with implanted permanent mechanical circulatory support represent a serious medical issue that requires careful management to reduce the incidence of complications and improve patient outcomes. Mechanical circulatory support, such as a ventricular assist device, has become an increasingly common therapy for patients with end-stage heart failure who are not candidates for heart transplantation. The driveline is a vital part of this system, connecting the internal part of the cardiac support to external components. However, its exterior location makes it susceptible to infections. Infections at the driveline exit site can be caused by various microorganisms, including bacteria, fungi, and rarely viruses. Risk factors include previous infections, poor hygiene, inadequate antibiotic prophylaxis, and other comorbidities such as diabetes or obesity. Diagnosis is usually based on clinical symptoms such as redness, swelling, or discharge around the driveline, and confirmed by sample cultures. Prevention of infections at the exit site of the percutaneous cable is crucial for improving patient outcomes. This includes strict asepsis during placement and maintenance of the driveline, regular monitoring of the wound, and education of patients and healthcare workers on proper care. Prophylactic antibiotic use may be considered in patients at increased risk. When an infection occurs, prompt action is important. Therapy typically involves systemic antibiotics targeted at the identified pathogen, with the possibility of local treatments such as wound irrigation or topical antibiotic application. Complications of driveline exit site infections can be serious, including sepsis, endocarditis, abscess formation, and permanent damage to the heart or other organs. Therefore, early recognition and aggressive treatment are crucial to prevent serious consequences. Long-term management of patients with permanent mechanical circulatory support includes regular check-ups, monitoring of driveline function, checking for possible complications, and support in lifestyle changes. Patient education about the signs and symptoms of infection and proper driveline care is essential for preventing recurrences.