The main concern of this chapter is to present pacing in the ICU setting. The purpose of cardiac pacing is to restore or ensure effective cardiac depolarization. Transcutaneous, transvenous, transthoracic, epicardial, endocardial and esophageal several approaches of pacing. Bradycardias and tachycardias are two types of indication of transcutaneous cardiac pacing. Pacing (pulse) generator, introducer sheath, pacing lead and connecting cable are equipment used in pacing in the ICU setting. Local site complications and complications of lead placement are two types of complication in cardiac pacing. Transcutaneous cardiac pacing (TCP) is a rapid, minimally invasive method of emergency cardiac pacing that may temporarily substitute for transvenous pacing. TCP is the fastest and easiest method of emergency pacing. TCP is also widely used in the prehospital environment, as well as, in the hospital, in the cardiac catheterization laboratory, operating room and intensive care units.