Cardiovascular diseases are a major cause of death worldwide. If medical treatments fail to restore adequate blood flow in a patient, mechanical support is needed. To date, many different types of blood pumps have been developed, but only few are clinically available. This review article describes the challenges involved in this field of research and gives an overview of the development process. Past developments as well as current and new technologies and approaches applied are summarized. Finally, a perspective for improved devices is discussed.