The liver transplant (LT) program at King Faisal Specialist Hospital & Research Center was first established in 1994 where 45 cavaderic liver transplants (CLT) were performed by an overseas foreign team, but unfortunately that program was suspended in 1996 due to many logistical difficulties. In April 2001, the LT program at KFSH&RC was reactivated again by a local team, and hereby we will present our recent experience. In the period between April 2001 and August 2004 we performed 42 liver transplant procedures, including 27 CLT and 15 living donor liver transplants (LDLT), the first two LDLT procedures were performed with the help of an experienced overseas surgeon, however, the following 13 cases were performed by our local team without outside support. Male/Female ratio was 22/20. Adult/pediatric ratio was 39/3. Out of those 42 patients, 39 (93%) survived after a median of 278 days (range 2-1190 days). We had two early mortalities due to primary non-function following CLT, and portal vein thrombosis complicating LDLT. One other mortality was due to aggressive HCV recurrence leading to late graft failure 3.5 years post CLT. Other serious complications included; hepatic artery thrombosis in 2 patients who were both salvaged by early surgical revision, biliay complications in 4 out o15 LDLT, irreversible brain damage in one recipient, Kaposi sarcoma in one patient, posttransplant lymphoprolifrative disease in one patient, and aggressive recurrent HCV in two patient. Both cadaveric and living donor liver transplants have been performed successfully at KFSH&RC with good outcomes. We believe that our well established CLT program has significantly contributed to the success of our LDLT program; this was particularly shown by our speedy ability to perform the procedure without the need for foreign support. We also believe that the outstanding medical expertise supporting our program at KFSH&RC; especially anesthesiologists, microvascular surgeons, interventional radiologists, as well as the unlimited support of the hospital administration have all given us the confidence to take the difficult decision of doing LDLT alone so early along the road.