Background <p>Allogeneic hematopoietic stem cell transplantation (allogeneic HSCT) is a&#xa0;curative treatment option and implicates the transplantation of healthy donor bone marrow or peripheral blood stem cells into recipients. The procedure represents a&#xa0;curative treatment option for children and adolescents with various hematological, oncological, immunological or metabolic diseases.</p> Material and methods <p>A&#xa0;literature review and evaluation of case numbers at the University Hospital Münster (UKM) Stem Cell Transplantation Center were conducted to assess risks and chances of allogeneic HSCT.</p> Results <p>The indications for transplantation are based on the current recommendations of national and international study groups and guidelines. Donor selection takes various factors into account and, due to the high-resolution human leucocyte antigen (HLA) typing, contributes to the success of the allogeneic HSCT. The preparatory high-dose chemotherapy and radiotherapy depend on the type of underlying disease, HLA match and various recipient factors. Once the donor stem cells have engrafted the immune system is reconstituted. During this time, complications, such as graft versus host disease (GvHD), infections or other severe complications can occur. These can be increasingly well-controlled due to improved supportive treatment. This has also led to an improvement in the prognosis in recent years.</p> Discussion <p>Complications can increase the morbidity and mortality. In some selected cases HSCT is being replaced by new treatment options, such as chimeric antigen receptor (CAR) T-cell or gene therapy. For other children and adolescents, it currently represents the only curative treatment option.</p>