There are few cases in the current literature that describe simultaneous heart and kidney transplant (HKTx) while on total artificial heart (TAH) bridge therapy. We present a case of successful HKTx after 318 days on TAH bridge therapy and renal replacement therapy. This case demonstrates that TAH placement is a unique and up-and-coming option for bridging patients with heart and kidney failure to HKTx. TAH is a promising bridging option for patients who do not qualify for left ventricular assist device placement. The survival rates to heart transplant and long-term outcomes after heart transplant on TAH bridge therapy are encouraging as well. However, it is crucial for clinicians to be vigilant of the wide variety of complications associated with TAH when managing patients on TAH bridge therapy.