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Long-term outcomes for pediatric patients with intestinal failure have significantly improved with advances in management of parenteral nutrition and the associated comorbidities. These changes have been driven by the development of multidisciplinary intestinal rehabilitation teams. Overall survival and transplant-free survival rates have increased while the introduction of new management strategies has decreased complications such as central line infections and intestinal failure associated liver disease. Factors have been identified that aid in prediction of duration of parenteral nutrition and time to enteral autonomy. Close long-term monitoring of growth and early evaluation of development are needed as abnormalities in both areas are common. With the improved survival, an important focus going forward will be the study of and improvement in quality of life for both children with intestinal failure and their families.