Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in China in December 2019 and has rapidly spread worldwide, leading to a global pandemic. Mortality rates among COVID-19 patients can reach up to 4.2%, and despite advances in medical care, some patients with end-stage COVID-19 pneumonia progress to irreversible lung injury, requiring intensive care support. Lung transplantation, traditionally used for chronic end-stage pulmonary diseases, has been rarely applied to acute infectious conditions like COVID-19 due to uncertainties regarding the reversibility of lung damage. However, recent cases demonstrate its potential as a life-saving intervention. In China, six critically ill COVID-19 patients received lung transplants as a last-resort treatment. Similarly, Europe witnessed its first successful COVID-19 lung transplant at the Vienna General Hospital, Austria, followed by a life-saving double lung transplant in an 18-year-old patient in Milan, Italy. These pioneering cases highlight the feasibility and importance of lung transplantation for select critically ill COVID-19 patients, emphasizing the need for careful patient selection and multidisciplinary management.