Inflammatory bowel disease affecting to large part of the intestine or with a high tendency to severe relapses, can originate a small bowel syndrome as consequence of massive or multiple intestinal resections. Thus, Crohn's disease is not an indication to small bowel transplantation (SBT) itself, but it could become one if several intestinal resections are performed. Nowadays, the outcome of patients with chronic severe intestinal failure treated with small bowel transplantation does not compare favourably with that of long term home parenteral nutrition (HPN), therefore the SBT must be considered only in long-term HPN patients who have developed severe or lifethreatening complications.