Dr. Karen Bailey is an Associate Professor at McMaster University, she has worked as a paediatric surgeon and the Pediatric Trauma program director at McMaster Children’s Hospital since January 1, 2010.  She Is the Division of Pediatric Surgery Academic Division Head and Clinical Teaching Unit Director. Dr. Nikhil Pai is an Associate Professor of Pediatrics through the Division of Pediatric Gastroenterology and Nutrition. He is medical lead of the Complex Pediatric Nutrition Clinic and Pediatric Intestinal Failure Program, co-Chair of the hospital’s Pediatric Nutrition Advisory Committee, serves on the Canadian Nutrition Society’s Canadian Malnutrition Task Force, and advises to Health Canada’s Fecal Microbiota Transplant Advanced Therapeutics Pathway. Pediatric intestinal failure is a rare disorder of many causes, that requires the multidisciplinary care of even more providers. Achieving good outcomes in this condition takes collaboration, translational science and leadership. In our session we will share the Pediatric Intestinal Rehabilitation Program’s work across these areas. In this session of Grand Rounds, Dr. Bailey and Dr. Pai review basic principles and pearls of managing pediatric intestinal failure in the 21st century, discuss expanding roles of local and national multidisciplinary teams in management and McMaster's work in advancing and leading intestinal failure management.