Vascularized composite allotransplantation (VCA) has emerged as a reliable treatment for restoring both form and function in patients experiencing substantial tissue loss. Various clinical VCAs, such as partial-face, full-face, hand, and knee allotransplantation, have demonstrated successful outcomes with excellent short- to intermediate-term functional results. While current immunosuppression protocols effectively suppress acute rejection, they come with notable side effects. Successful strategies to minimize immunosuppressant dosage have been developed and applied, although achieving favorable long-term outcomes requires careful follow-ups. Addressing this knowledge gap, our work employs murine VCA models to explore strategies for enhancing outcomes. This presentation will delve into our efforts, which include applying co-stimulation blockade, vascularized bone marrow transplantation, and immunosuppressant-hydrogel complexes to successfully improve VCA outcomes.