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This review aims to provide an overview of the complex topic of limb replantation. The historical developments in limb replantation are detailed and the technical considerations of this surgery are discussed. Specific concerns relating to limb replantation surgery such as total ischaemic time and the amputation level are considered. It is important for rehabilitation to be tailored to the individual and the level of the injury. Attempted upper limb replantation is advocated in most cases but lower limb replantation is rarer. Lower limb replantation may have successful outcomes provided careful selection of patients takes place. Future improvements in replantation surgery may be influenced by developments in limb allograft surgery and nerve regeneration. Despite varying outcomes following successful replantation surgery, patients generally prefer to retain their own limbs rather than have a prosthesis and this should be considered as part of the informed decision making process by clinicians.

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