Iran is located in Middle East with 98% of its 68 million population being Muslims. Tissue transplantation has a long history in Iran. Avicenna, the great Iranian physician, performed the first nerve repair in 11th century. Cornea was the first tissue transplantation in 1935. The Central Eye Bank of Iran was established in 1991 and Iranian Tissue Bank (I.T.B) was set up in Imam Khomeini Hospital (Tehran –Iran) in 1994. In the first 2 years of activity fresh homograft heart valves were prepared for clinical use, then cryopreservation techniques was implemented to enhance efficacy and facilitate long term storage of prepared homografts. The current products of I.T.B are homograft heart valves, amniotic membrane, cartilage, bone segments and soft tissues. In the beginning of I.T.B‘s activity, lack of legislation was the main obstacle against tissue donation. Fortunately, in response to our istifta (religious question) most of prominent scholars have pointed out positive opinion (Fatwa) regarding organ and tissue donation. These religious rulings helped us to start tissue donation before legislation. The act of “Deceased or Brain dead patient organ transplantation” was passed on April 6, 2000 by the parliament. Despite there is not a separate legislation for tissue donation and transplantation but the legal frame work is the same as organ transplantation. According to the law, informed consent is obtained from the next of kin. Despite the importance of religion and legislation, it seems that the main barriers against organ and tissue donation are socio-cultural factors, family relations, lack of knowledge and filial obligations. So I.T.B has conducted many educational programs and propaganda with support of mass media. The result was a considerable growth in number of tissue donors. From 1994 to the end of 2007 the number of tissue donors was more than 3300 that 84% of cases were after legislation.