Anorectal transplantation (ART) belongs to the emerging field of vascularized composite allotransplantation. Researchers have studied this procedure experimentally for over two decades as a strategy to restore anal function in patients with severe fecal incontinence and permanent colostomy. These conditions significantly impact the quality of life and pose a global public health issue. This narrative review provides a comprehensive analysis of anorectal transplantation research, covering experimental studies in animal models, and ex vivo investigations. It examines and compares different surgical techniques, considering both procedural effectiveness and functional recovery. These experiments indicate that ART can be successfully performed from a technical standpoint. Ex vivo studies demonstrate acceptable surgical times, and studies in animal models confirm graft viability and functional restoration. Future research should refine surgical techniques, investigate neural regeneration mechanisms, and develop immunosuppressive protocols to advance the field toward clinical application. ART holds the potential to completely change the treatment of severe anorectal dysfunction and permanent colostomy, offering a definitive solution to these irreversible conditions.