Heart disease is the leading cause of death for many children in the country. According to a report by the National Heart Institute, as many as 80% of pediatric patients receiving treatment at the National Heart Institute (IJN) are in dire need of treatment funds. Various zakat assistance schemes have been introduced by zakat centers through the State Islamic Religious Council (MAIN) to ease the burden of heart disease patients to finance their treatment costs. However, most of the assistance schemes introduced are only general in nature and not specifically for heart disease patients. Therefore, this article aims to discuss the need for ijtihad and fatwa related to the zakat assistance scheme for the cost of heart treatment by fatwa and zakat institutions. The study will also discuss the health assistance schemes provided by the State Islamic Religious Council This qualitative study uses documentation and observation methods in the data collection process. The results of the study found that ijtihad and zakat fatwa in health assistance schemes have been implemented at the institutional level of fatwa and zakat in the general context. There are also several states that have provided zakat funds specifically for heart disease patients. It is hoped that this study can provide guidance and reference to fatwa institutions, zakat institutions, IJN and certain organizations to help asnaf with heart diseases to recover through ijtihad and fatwas issued. A further study on the effectiveness of zakat funds on the cost of heart treatment for heart disease patients can be implemented to ensure the well -being of Muslims in Malaysia.