For a type I diabetic patient, a whole-organ pancreas transplant is the best option for permanent restoration of normoglycemia. This paper reviews data from the International Pancreas Transplant Registry and the literature from the past few years to provide an overview on the current status of pancreas transplantation. The use of living-related versus cadaveric donors, a review of surgical technique, the detection and treatment of rejection, and the effects of pancreas transplantation on the complications of diabetes are considered. The role of pancreas transplants alone (without simultaneous kidney transplants) in the control of diabetes is examined.