Liver transplantation with left split liver is an excellent alternative to whole liver transplantation to respond to demand for organs in the pediatric population. In the face of a complex surgical technique that requires specific liver transplantation expertise, skills in resection and anatomical and pathophysiological knowledge deriving from deep hepatobiliary experience are of great relevance. Results in terms of outcome are now almost comparable to the use of whole liver. Limited space is still reserved to the use of split liver for two adults (full-right full-left) to meet the demands of the adult waiting list as well, because it is a technically challenging surgical procedure. The surgical technique is diversified and in continuous refinement, and now includes the possibility of applying dynamic preservation devices to reduce organ injury and ischemia time.