Intestinal transplantation is now considered a life-saving option for patients with intestinal failure. Progress in this field since it became clinical reality with tacrolimus-based immunosuppression has improved posttransplant mortality and morbidity. Though early outcome and 1-year survival data have improved, there is continuing graft and patient loss with time. Parenteral nutrition remains the mainstay of therapy for patients with intestinal failure. Parenteral nutrition–dependent patients who develop life-threatening complications of parenteral nutrition are the primary candidates for intestinal transplantation. It is hoped that indications are broadened as further advances in intestinal transplantation improve the outcome.