Cardiac implantable electronic device (CIED) infections can have devastating implications on patient morbidity and mortality. Over the past decade, the infection rate has risen out of proportion to implant rates, potentially related to the prevalence of multiple comorbidities and risk factors in patients who require these devices. The recognition of this morbidity and mortality has prompted the development of innovative solutions designed to reduce infections. These innovations are the subject of this review. The first section of this review provides a summary of the contemporary knowledge regarding the incidence, prevalence, microbiology, and risk factors for cardiac implantable electronic device infections, and the second section addresses prevention with an emphasis on the role of novel procedural approaches, such as capsulectomy and the antibacterial envelope, in reducing CIED infection.