Vascularized composite allotransplantation (VCA) is a surgical procedure involving the transplantation of living tissue comprised of muscle, bone, tendon, nerve, and skin from a donor to a recipient. Virtual surgical planning (VSP) has been utilized in-vivo for upper extremity VCA to improve efficiency—and therefore survivability—of living donor tissue. The senior author herein describes their development and application of VSP for upper limb transplantation.