Indications of endocarditis prophylaxis have changed in the past years, because of the absence of any evidence that justified its use. The last guidelines only recommend prophylaxis in patients with underlying cardiac conditions with the higher risk of adverse outcomes, including patients with a previous history of infective endocarditis, patients with prosthetic heart valve or prosthetic material used for valve repair, patients with a valvulopathy after cardiac transplantation, and patients with an specific congenital heart disease. The list of procedures in which prophylaxis is necessary has been limited too. Nowadays it is recommended in patients who undergo any dental procedure that involves the gingival tissues or periapical region of a tooth and for those invasive procedures of the oral cavity or an invasive procedure of the respiratory tract that involves incision or biopsy of the respiratory mucosa. In this revision we try to expose the recent tendencies recommended by the international guidelines.