Chagas disease continues to be an important cause of cardiac disease in many countries of Latin America. Dilated cardiomyopathy constitutes the more severe manifestation and main cause of death in the disease. Typical clinical presentations include three basic syndromes: heart failure, cardiac arrhythmia and thromboembolism. The identification of markers related to the progression of Chagas heart disease is relevant for appropriate patient management. The most important predictors of death are New York Heart Association functional class, left ventricular systolic dysfunction and nonsustained ventricular tachycardia, which reflect the severity of myocardial damage. Several other potential prognostic factors have recently been reported. Scores for mortality prediction using a combination of prognostic variables have contributed to overall improvement in risk stratification in the setting of Chagas disease.