Abstract: Generally, total or subtotal pancreatectomy induces an inevitable loss of partial or even all of the pancreas, which brings about impaired glucose tolerance and diabetes mellitus.To protect the pancreatic endocrine function, islet auto-transplantation from the resected pancreatic tissues has gradually been valued. This article reviews the 40-years progress of islet auto-transplantation since 1977 when the first case was reported, including the progress in the techniques of islet isolation, purification, and transplantation, improvement of postoperative insulin independency, and expansion of the indications. We also discuss the current status and the difficulty of islet auto-transplantation, and finally forecast its prospect.