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Normothermic machine perfusion (NMP) is a preservation method that is generating increasing interest. The aim of this review is to summarise the current status of NMP in regards of kidney viability assessment, reducing organ damage and improving transplant logistics.The results of recent large animal experiments and clinical trials show that continuous prolonged normothermic ex-vivo kidney perfusion appears better than a brief period of NMP after static cold storage in terms of renal injury and function. A recently developed clinical scoring system appears to correlate with renal and tubular function. A prospective clinical phase II trial to investigate the initial graft function after 1 h of NMP or static cold storage in kidneys from donors after circulatory death has been initiated in the United Kingdom.Progress has been made in normothermic kidney perfusion, mainly in experimental settings. These results need to be translated into clinical trials to evaluate long-term NMP and its impact in human organs. Future investigations of optimal perfusion parameters are needed.