Liver transplantation is the only possibility for a cure and a future normal life in patients with end-stage liver disease. It is one of a most complex procedures in modern medicine. The most common indications for liver transplantation in children are biliary atresia, acute liver failure, pediatric autoimmune liver disease, and liver disease after pediatric transplantation. The liver transplant program in children in the Republic of Croatia was founded in September 2001 and is carried out at KBC Zagreb. Advances in transplantation techniques have been achieved through improvements in surgical techniques and the advent of new immunosuppressive drugs. Although most transplanted children have a good quality of life, significant complications persist, including vascular and biliary problems, intestinal perforation, graft rejection, infection, high blood pressure, and long-term kidney damage. The timing of the transplant is extremely important. New techniques increase the number of donors and reduce waiting lists, and progress in immunosuppressive therapy leads to improved quality and life expectancy of patients. New liver transplant techniques evolve, such as dividing a single liver to perform two transplants simultaneously, both in a child and an adult. Likewise, in the case of hereditary metabolic diseases and hepatitis, temporary auxiliary liver transplantation is performed in the acute phase of the disease. Standardization of surgical technique, development of better immunosuppressive drugs, better understanding of the treatment of end-stage liver disease, improvement of anesthesia and intensive care treatment have a great impact on patient survival. Early recognition of complications after liver transplantation, as well as good knowledge of the vascular anatomy of the donor and recipient, is crucial for patient survival.