The small bowel is the organ responsible for the absorption of water and nutrients. Short bowel syndrome (SBS), a medical condition characterized by a viable intestine that is less than 200 cm long, is frequently associated with intestinal failure (IF). IF is defined as a condition in which intestinal function does not allow adequate absorption of water, electrolytes, and nutrients, requiring parenteral administration. Nutritional support, along with drug and surgical treatment, is the cornerstone of therapy for patients with SBS and IF. Parenteral nutrition (PN) is essential in the management of these patients, being indispensable during the postoperative period until the intestinal adaptation process is achieved. Unfortunately, many patients with SBS require long-term PN, sometimes lifelong. Home parenteral nutrition (HPN) has led to important advances in disease management, with increased survival and quality of life; however, it is also associated with risks of complications and increased costs. Enteral nutrition (EN) is considered an adjunctive therapy, providing benefits for intestinal adaptation and helping to wean patients off parenteral nutrition (PN). A better understanding of the pathophysiological processes of intestinal adaptation and IF, the integration of a nutritional approach within a multidisciplinary therapeutic framework, and advances in medical and surgical therapies will lead to a more favorable prognosis and improved quality of life for patients with SBS.