Abstract Transplantation of thymic tissue was initially attempted in the 1960s and 1970s. Long-term successes were rare but these studies served as an important foundation. Today, cultured thymus tissue transplantation (CTTT) is performed for athymic infants. Almost all CTTT recipients are infants with complete DiGeorge anomaly. CTTT is an investigational product regulated by the FDA. Duke is only center in the United States performing thymus transplantation and this chapter reviews the experience to date.