Lung transplantation is an accepted mode of therapy for patients with end-stage pulmonary vascular or parenchymal diseases. To date, application to the pediatric age population in general, and the infantile group in particular, has been limited both in terms of number of transplants and follow-up thereafter. We performed our first transplant in an infant in 1993 and have performed 30 lung transplants in children under 1 year of age subsequent to that. This chapter will review the experience to date including indications for transplantation, post-transplant management, complications, and long-term follow-up.