Mast cells originate from pluripotent progenitor cells in bone marrow and are major players in the inflammation process. The involvements of mast cells in various cardiovascular complications such as arrhythmias, ischaemia reperfusion injury and graft rejection are well documented. Moreover, recent studies suggest the involvement of mast cells in cardiac hypertrophy and heart failure. The present review focuses on the role of mast cells in the development of cardiac hypertrophy and heart failure.