No storage method for biological materials preserves the full functional integrity of all cells in a given population. The loss of cells during storage of tissues for transplantation has to be accepted and the purpose of storage is to minimize both cell loss and maintain functional integrity. This is especially important for tissues where integrated cellular function is essential for normal, overall physiological function of the tissue. This is the case for cornea intended for transplants that require an intact and functioning corneal endothelial monolayer, such as for endothelial disease. The three main approaches to corneal preservation, viz., organ culture, hypothermic storage and cryopreservation, all pose their own unique challenges to cells and present a range of differing mechanisms of damage. Hypothermia relies on the suppression of metabolism by reduced temperature. Organ culture attempts to maintain metabolism. Cryopreservation completely suppresses all biochemical reactions and offers the prospect of indefinite storage. A better understanding of these mechanisms may lead to improvements in the quality of tissue after storage.