Surgical management of short bowel syndrome comprises highly tailored and patient-centered techniques aimed at maximizing intestinal absorptive capacity and optimizing transit time. Such techniques include restoring continuity, performing strictureplasty, and employing bowel-lengthening procedures to increase functional length. In refractory cases, intestinal transplantation may be required. A multidisciplinary team approach is essential for perioperative optimization, long-term follow-up, and nutritional management, with the goal of improving quality of life and reducing or eliminating the need for parenteral nutrition.