Abstract Background: The aging process may be associated with the accumulation of a wide variety of health damages, such as cardiovascular diseases. HF is the final common path of the majority of these diseases, and, in its refractory form, heart transplantation continues to be the best treatment choice. Objective: To describe the demographic and epidemiological profile of aging and elderly patients receiving heart transplant from 2009 to 2018. Methods: Retrospective, descriptive longitudinal study on heart transplantation in aging and elderly patients using data from medical records and institutional documents. Results: From a total of 234 transplant recipients, 127 were 45 years or older. For the demographic profile, the variables used were sex, age, marital status, home state, and profession. For the epidemiological profile, the variables used were previous diagnosis, comorbidities before and after transplantation, and survival. Age varied from 45 to 74 years, with a mean of 57 years. The male sex accounted for 58.27% of recipients, and 59.84% were from the Federal District. Chagas, dilated, and ischemic cardiomyopathy accounted for 66.14%, 18.9%, and 14.17% of transplants, respectively. The main comorbidities were Chagas disease (66.14%), malignant arrhythmia requiring cardioverter-defibrillator implantation (28.35%), arterial hypertension (27.56%), and dyslipidemia (15.75%). Mean survival was 3 years and 4 months. Conclusion: The demographic profile showed that the majority of patients were aging, male, married, and from the Federal District. The epidemiological profile showed that Chagas cardiomyopathy was the main cause of HF, followed by dilated cardiomyopathy.