Intestinal transplantation is carried out in only a handful of centers in the world. However, patients with such transplantation may be seen at almost any institution and radiologists should be familiar with the expected normal anatomy and complications of intestinal transplantation and its variants. In this paper, we discuss the anatomy and complications following intestinal and multivisceral transplantations. We review the literature and present the findings in a cohort of 46 patients who underwent these procedures at our institution. It is important not to misinterpret the normal adaptation of the transplanted intestine for disease. Some of the complications, including infections, vascular complications, and recurrent tumor, are conclusively diagnosed on imaging studies. Imaging studies may raise the diagnosis of complications such as rejection, graft-versus-host disease, posttransplant lymphoproliferative disease, and sclerosing peritonitis.