Home parenteral nutrition (HPN) is the cornerstone of long-term management for patients with chronic intestinal failure (CIF), most commonly caused by short bowel syndrome. This chapter provides a comprehensive overview of the indications, implementation, monitoring, and complications of HPN. Emphasis is placed on patient selection, central venous access management, individualized nutritional formulation, and multidisciplinary care. This chapter also discusses the metabolic, hepatic, renal, and bone-related complications associated with long-term HPN and outlines strategies to mitigate these risks. Operational and healthcare system considerations, including cost and program structure, are addressed to support the safe and sustainable delivery of HPN. A structured, multidisciplinary approach remains essential to optimize outcomes and quality of life in this vulnerable patient population.