The incidence of Intestinal Failure (IF) in children is estimated to be 1–2 per million population. In children, the causes of IF are: short bowel syndrome, disorders of bowel motility and primary mucosal disease (Table 12.1). The indications for Intestinal transplantation (ITX) in children are irreversible intestinal failure (IF) associated with complications such as: loss of central venous access or life threatening line sepsis. A combined liver/intestine transplant is indicated if the child has developed intestinal failure associated liver disease (IFALD). Children should be considered for intestinal transplant assessment before they develop irreversible multi-organ failure.