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Small bowel/multivisceral transplantation (SB/MVTx) was described in dogs more than 30 years ago,[1] but clinical application was first attempted in the 1980s. The first successful case with long-term survival of a multiorgan recipient was described by Starzl in 1989. He performed the procedure in a pediatric recipient who lived over 6 months. [2] However, the initial clinical experience was associated with high mortality and morbidity rates. [3] The development of new immunosuppressive protocols, the refinements in surgical technique and in critical care as well as better candidate selection have improved the clinical outcomes of SB/MVTx, making it a lifesaving procedure for patients with irreversible intestinal failure who can no longer be maintained on total parenteral nutrition (TNP). This report describes the results obtained with our first nine SB/MVTx procedures.