Aim: This article describes the clinical management of tooth transposition. Treatment options, including alignment in the transposed positions, extraction of one or both transposed teeth, and alignment to their normal position in the arch, are discussed in terms of the age at which the transposition is discovered and the severity and completeness of the anomaly. Subjects: Following a thorough literature review, different cases of transposition are presented to demonstrate treatment considerations and orthodontic solutions. The “pros” and “cons” of aligning transposed teeth into their normal position in both arches are described. Results and Conclusion: A logical and relatively predictable treatment solution should be considered. However, in some selected cases, it may be advisable to employ more complex treatment solutions. World J Orthod 2003;4:333–342.