The experimental investigation of heart transplantation began almost 100 years ago, but it was not until the studies at Stanford Medical School in the late 1950s and early 1960s that clinical transplantation became a realistic possibility. Barnard performed the 1st human-to-human orthotopic heart transplantation in 1967, and followed this by introducing the technique of heterotopic heart transplantation in 1974. Reitz and colleagues at Stanford performed the 1st successful clinical transplantation of the heart and both lungs in 1981. Two years later, at the Toronto General Hospital, successful single-lung transplantation was performed, followed by bilateral lung transplantation in 1986. Aspects of the surgical techniques of these various experimental and clinical procedures are discussed.