Young people with a chronic illness or disability originating in childhood ultimately need transition to adult care. The process of leaving a familiar paediatric service and effectively engaging in appropriate adult health care can be challenging and complex. The process often occurs when there are other significant transitions in a young person's life. Australia has a number of state-wide transition initiatives, which aim to address the consistent themes of transition including health care equity, information transfer between health services, consumer participation and the engagement of adult services. What is apparent is the need for the development of transition models, ideally by collaboration between paediatric and adult services, which can be trialed and evaluated in order to best inform how resources need to be distributed. It is also clear that there will be a number of models, defined by the specific disease process. There should always be an emphasis on the needs and wellbeing of young people with chronic illness and the acknowledgement that they should be supported in their quest to lead a normal life.