Abstract
Remarkable progress has occurred in clinical islet transplantation, and with over 1000 patients treated in the past 12 years, this therapy has moved from status of curiosity to realistic treatment for selected patients with type 1 diabetes complicated by refractory glycemic lability. The current chapter discusses indications for the procedure, provides a practical approach to optimal immunosuppressive and adjunctive management, discusses potential risks, long‐term outcomes and advances in post‐transplant treatment aimed at further moving this treatment closer to a potential cure, or at the very least, more widely available therapy, for diabetes.