The field of transplantation continues to evolve. In the years since the first publication of the Transplantation Drug Pocket Reference Guide, the therapeutic armamentarium for transplantation has grown. The introduction of new agents continues to enhance our ability to improve the short- and long-term success of transplantation. The fifth edition of the guide, now entitled Transplantation Drug Manual, includes information on agents approved for use in transplant recipients. As in previous editions, we compiled practical information on the wide array of pharmaceutical agents currently available–both those used for immunosuppression and those used to minimize posttransplant complications. The agents described here are the most frequently prescribed drugs in the Transplant Service at the University of Wisconsin. We hope you find this information to be useful and practical in managing the transplant patient.