Combined organ transplants have been utilized since the early years of liver transplantation, having demonstrated clear benefits in the treatment of various conditions. In this chapter, we provide a comprehensive overview of simultaneous liver and second-organ transplantation, with a focus on simultaneous liver-kidney, liver-heart, and liver-lung transplants. We examine the medical literature surrounding these complex procedures, addressing key topics such as indications for combined transplantation, patient selection criteria, pre- and postoperative management, and overall outcomes. By synthesizing current evidence and clinical practices and highlighting the challenges and advancements in multi-organ transplantations, this chapter offers valuable insights into the evolving field of combined organ transplantation and its impact on improving patient quality of life and long-term survival.