Intestinal failure remains a cause of morbidity and mortality in children and adults. Currently intestinal failure patients must be evaluated by a multidisciplinary team in order to optimize parenteral support, to determine the chances for rehabilitation or the need for transplantation. Intestinal transplant has been the last abdominal organ to evolve. Indications and procedures have been refined and standardized; new immunosuppressive drugs and the experience of treating these patients in a limited number of centres have reduced complications and improved survival. Forty years after the first attempt, intestinal transplant can now be successfully performed in Latin-America. The aims of this review are to update the current status of intestinal transplant, to highlight new developments and the evolution in our continent and to provide the basic knowledge in the management of intestinal failure patients for nutritionists, gastroenterologists and surgeons.