The status of liver transplantation has evolved over 5 decades from that of a high-risk procedure of debatable benefit to that of a standardized treatment for end-stage liver disease. Advances in preservation technology, surgical technique, immunosuppressive medication and protocolized perioperative care have all been critical to this success. Inevitably this success has resulted in the indications for liver transplantation expanding, thereby generating a major donor organ shortage, with waiting list deaths in most countries. Liver preservation has relied on static cold storage (SCS), the primary functions of which are to reduce metabolic activity and cellular swelling during storage and transport. However, with the ever-present need to increase the utilization of high-risk livers (particularly those from extended criteria donors which are particularly susceptible to cold ischemic injury) alternative nonstatic preservation strategies have gained popularity. This chapter will cover the principles and practice of liver preservation, including some of the newer technologies that are beginning to impact on the field.