The complications of IE may involve any organ system. Cardiac complications are frequently present, and heart failure remains a leading cause of death. Abscess formation in the surrounding cardiac tissues may result in myocardial or pericardial disease, and cardiac conduction abnormalities may develop. Extracardiac complications, including neurologic, vascular, and renal diseases, are also common and are usually caused by either embolization of vegetations or deposition of immune complexes. Despite many advancements in the detection and treatment of the complications of IE, management of these problems remains a challenging endeavor.