Living donor liver transplantation (LDLT) has now become an important part of many liver transplantation programs around the world. While adult-to-adult LDLT remains the transplant procedure of choice in most Asian countries due to the lack of deceased donors in these areas, LDLT is less commonly undertaken in Western countries because of the greater availability of deceased donors. This is especially true for the UK following a recent increase in the deceased donor pool (especially donation after circulatory death (DCD) grafts). LDLT now accounts for 7% of liver transplants performed per year in the UK, the majority of which are performed in three centres. This is the first national guideline in this rapidly evolving field. It aims to review the current evidence relating to the evaluation process of both recipient and donor candidates; to address the moral and ethical issues surrounding this procedure; to outline the technical aspects of the procedure, including the middle hepatic vein controversy and the ‘small for size syndrome’; to review donor and recipient outcomes and complications including donor mortality; and to examine evidence relating to the advantages and disadvantages of LDLT.