Successful heart-lung transplantation has now been accomplished in the clinical setting. Experimental work in this field began some 40 years ago, and there were even sporadic attempts at clinical application, but it was not until currently available immunosuppressive techniques were developed that this procedure became a clinical reality. This paper reviews experimental work to date, prior attempts at clinical heart-lung transplantation, the Stanford clinical series to the present, and the important aspects of management of these patients.