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This review provides a summary of the applications and potential applications of metabolite profiling (i.e. metabolomics) in monitoring organ transplants. While the concept of metabolomics is relatively new to organ transplantation, the idea of measuring metabolites as a quick, noninvasive probe of organ function is not. Indeed, metabolite measurements of serum creatinine have long been used to assess pre- and post-operative organ function. Over the past 10 years, a number of lesser-known, organ-specific metabolites have also been shown to be good diagnostic indicators of both organ function and viability. In general, metabolomics offers a complementary picture to what can be revealed via techniques based on genomics, proteomics or histology. Because metabolic changes typically happen within seconds or minutes after an ‘event’, whereas some transcript, protein abundance or tissue changes may take place over days or weeks, metabolomic measurements may offer a particularly useful and inexpensive diagnostic tool to monitor donor organ viability or to detect organ rejection. The excitement associated with metabolomics, however, must be tempered by the fact that the technology for rapid metabolite identification is still in its infancy, and that metabolites are but one part of a very complex picture pertaining to organ function.