The discovery of a powerful immunosuppressive, cyclosporin A, together with the development of a microsurgical free tissue transfer technique, has brought extremity transplantation closer to being a realistic possibility. In this review the authors describe the history of laboratory research into extremity transplantation before immunosuppression, with early immunosuppressive agents, with cyclosporin A, and with FK-506, one of a new generation of immunosuppressives.