Laparoscopic live donor nephrectomy was first performed clinically in 1995. The original hypothesis that provided the impetus for the development of this operation was that the reduction of postoperative pain and recuperative time would decrease logistical and financial disincentives to live kidney donation, thus increasing the number of live donors and the organ supply. Its introduction sparked a contentious debate over its appropriateness and safety. However, over the past 5 years a growing body of literature has accumulated that now supports this original hypothesis. Laparoscopic live donor nephrectomy has been shown by a variety of centers to be safe and advantageous for the donor. Refinement of the operation and a better understanding of the renal effects of pneumoperitoneum have yielded recipient results that are comparable to those seen with the open donor operation. Largely driven by patient demand, a large number of centers have now adopted this procedure. Laparoscopic live donor nephrectomy is on the verge of evolving into the new standard for live donor surgery.