AbstractSmall bowel transplantation may offer a future alternative to patients with short bowel syndrome. However, currently available immunosuppressive regimens are not adequate to prevent rejection of small bowel allografts. Recent experimental studies using cyclosporine have provided improved results, especially in rats; but there are relatively few long‐term survivors in large animal models. Graft‐versushost disease may result from lymphoid tissue in the small bowel transplant but is less troublesome than rejection. Seven patients have undergone small bowel transplantation; the longest survivor died at 6 months. Clinical application of small bowel transplantation must await further refinements in immunosuppression.