Liver transplantation (LT) remains the only curative treatment for patients with failed medical treatment for acute-on-chronic liver failure (ACLF). However, the selection criteria for LT in ACLF is ill-defined. Given the scarcity of deceased organs and the inherent risk of living donor hepatectomy, it is mandatory to identify unfavourable prognostic factors for survival in ACLF in order to establish an objective and fair selection criteria for LT, and more importantly to ensure a satisfactory post-transplant outcome. The aim of this article was to review the current evidence on the validity of the existing prognostic models and to evaluate the survival outcomes after LT for ACLF.