Autotransplantation of teeth, if carried out successfully, ensures that alveolar bone volume is maintained due to physiological stimulation of the periodontal ligament. Autotransplantation has been carried out for many years, but with varying success rates. As a result, it is seldom regarded as an appropriate treatment option for patients with missing teeth especially with the continued development of osseo-integrated implants. Since placement of osseo-integrated implants in growing alveolar bone is contra-indicated, transplantation of available teeth remains a suitable choice for replacing missing units in the young patient. The role of autotransplantation of teeth in several clinical situations, the clinical techniques involved and factors influencing success of the transplant are discussed. The aim of this paper is to underline the evidence based principles for successful autotransplantation and present the technique as a viable treatment option in present day orthodontic practice.