The future of pancreatic transplantation for potentially eliminating type I DM as a major health hazard promises to be fascinating. The development of less toxic immunosuppressive regimens would allow broader applications of the procedure as well as possibly eradicating type I DM relatively early. Transplantation of cultured fetal pancreas cells may become a reality as a successful graft technique. Earlier means of detecting pancreatic rejection are currently under investigation and should come to fruition. In nonuremic individuals, the results of pancreatic transplantation on reversing or stabilizing the microangiopathic complications of type I DM are encouraging but have not yet produced definitive conclusions. Therefore, the procedure must still be considered experimental. On the other hand, combined pancreatic renal transplantation or pancreas transplantation after renal transplantation, a two-stage procedure, should be offered to all type I diabetics who are candidates for renal transplantation.