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The transition of healthcare from pediatric to adult settings has become more significant over the past 20 years as the survival of young people with chronic illness and disability has increased and healthcare delivery has become more complex. This review examines the evidence from recent studies and position statements to determine the current issues relating to transition.Although there are many examples of excellent transition processes, these are mostly confined to individual clinics (often subspecialist), with little evidence of hospital-wide or regional planning. The notion of transition to adult healthcare has now spread from its roots in adolescent medicine to influence many subspecialty areas of practice. However, it remains largely confined to a pediatric paradigm and risks becoming disconnected from the principles and practice of adolescent medicine from which it emerged.More systematic investment in regional clinical service planning is indicated, as is investment in more systematic approaches to training both pediatric and adult healthcare providers around the importance of transition to adult healthcare. Collaboration is urged in relationship to clinical service developments, training and research initiatives.