This chapter reviews the state of the art of ovarian transplantation as it pertains to the whole ovary. It also discusses strategies devised to minimize the initial post transplantation ovarian ischemia. Whole ovary transplantation with a vascular anastomosis was proposed as a mechanism to reduce ischemic time and, in theory, prolong the longevity of the graft. Fresh whole ovary transplantation with vascular anastomosis has been successfully performed using a wide variety of orthotopic and heterotopic recipient sites. Modifications of slow freezing cryopreservation protocols were implemented in ovarian tissue freezing as an integrated strategy for fertility preservation. The current evidence suggests that whole frozen thawed ovary transplantation may be successful in humans in the future. However, the significant depletion of the primordial follicle reserve observed after transplantation in animals is a major problem that needs to be further addressed at the experimental level prior to attempting that approach in humans.