peer reviewed ; Intestinal transplantation (ITx) has evolved from an experimental procedure towards a clinical reality but remains a challenging procedure. The aim of this survey was to analyze the multicenter Belgian ITx-experience. From 1999-2014, 24 ITx in 23 patients were performed in Belgium, divided over 5 centers. Median recipient age was 38 years (8 months-57 years); male/female ratio was 13/10; 6 were children and 17 adults. Intestinal failure was related to intestinal ischemia(n=5), volvulus(n=5), splanchnic thrombosis(n=4), Crohn(n=2), pseudo-obstruction(n=2), microvillus inclusion(n=2), Churg-Strauss(n=1), necrotizing enterocolitis(n=1), intestinal atresia(n=1) and chronic rejection(n=1). Graft-type was isolated ITx(n=9), combined liver-ITx(n=11) and multivisceralTx(n=4). One was a living donor-related transplantation and five patients received simultaneously a kidney graft. Early acute rejection occurred in 8; late acute rejection in 4 and chronic rejection in 2. Two patients developed a post-transplant lymphoproliferative disease. Nine patients have died. Among 14 survivors at last follow-up, 11 have been transplanted for more than 1 year. None of the latter has developed renal failure and all were nutritionally independent with a Karnofsky score >90%. 1-/5-year patient and graft survivals were 71.1%/62.8% and 58.7%/53.1%, respectively. Based on this experience, ITx has come of age in Belgium as a life-saving and potentially quality of life restoring therapy. This article is protected by copyright. All rights reserved.