In this chapter, we focus on the use of normothermic regional perfusion (NRP) in organ transplantation, particularly from a European perspective. NRP is a technique employed to provide in situ perfusion to donor abdominal organs after warm ischemia, enabling the regeneration of energy stores before transitioning to cold ischemia. This approach has been widely adopted in Europe due to its ability to enhance organ viability, facilitate graft evaluation, and improve transplant logistics. We review the historical development of NRP, its mandatory integration in certain European countries, and the technique’s impact on organ recovery. Additionally, the chapter explores the combination of NRP with other perfusion techniques, its technical implementation, and the observed clinical outcomes in liver transplantation.