As techniques for immune suppression improve, the clinical utility of small bowel transplantation will increase. Recent reports of long-term (over 1 year) survival with totally enteral nutrition following bowel transplantation have increased interest in this area and prompted the present review of the state of the art of small bowel transplantation. Background methodology is emphasized, in order to allow for more critical review of reported models, and to provide a framework for comparing results. The functional capacity of bowel following transplantation, and the effects of immune suppression on bowel function are reviewed in detail. Prospects for future direction in basic and clinical research are discussed.