Since the introduction of microsurgical technique over 40 years ago, replantation of the upper extremity has been performed throughout the world with regularity. Instead of focusing solely on survival of the replanted parts, hand surgeons are more aware of the functional, health-related quality of life and economic issues associated with this complex procedure. Derived from several decades of experience, the indications for replantations in the upper extremity have become more defined and the functional outcomes have improved. In indicated cases, replantation procedures provide patients with reconstruction that is unmatched by any other means. This article discusses the current status of replantation and condenses the particulars of performing upper-extremity replantations. Copyright © 2002 by the American Society for Surgery of the Hand