Pancreas transplantation is the only treatment of diabetes mellitus providing complete insulin-replacement therapy and restoring physiologic glucose homeostasis. Newer immunosuppressive agents and the development of surgical techniques have resulted in the improvement of long-term graft and patient survival rates which have been noted in recent years. This review article describes the types of pancreatic transplantation, surgical options, indications and recipient evaluation, donor criteria, infectious and technical complications, contemporary immunosuppressive treatment, short- and long-term results and patient benefits.