The article presents a European consensus conference on faecal microbiota transplantation (FMT) in clinical practice, led by 28 experts from 10 countries. The conference aimed to develop evidence-based recommendations for the use of FMT in treating *Clostridium difficile* infection (CDI) and other disorders associated with gut microbiota alterations. The consensus process involved an electronic Delphi method and a plenary meeting, with statements on FMT indications, donor selection, preparation of faecal material, clinical management, and basic requirements for establishing an FMT centre. The recommendations emphasize the importance of FMT as a highly effective treatment for recurrent CDI, with a strong recommendation for its implementation in clinical practice. The consensus report also highlights the need for standardized donor selection, preparation, and delivery protocols, as well as the establishment of FMT centres with appropriate facilities and governance. The report discusses the safety and efficacy of FMT, noting its excellent safety profile in the short term but acknowledging the lack of long-term data. It also addresses the use of FMT for other conditions, such as inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), but notes that evidence-based recommendations are limited. The consensus emphasizes the importance of rigorous donor screening, proper storage and preparation of faecal material, and the need for multidisciplinary teams to implement FMT centres. The report concludes with recommendations for regulatory frameworks, data collection, and long-term monitoring to ensure the safe and effective use of FMT in clinical practice.The article presents a European consensus conference on faecal microbiota transplantation (FMT) in clinical practice, led by 28 experts from 10 countries. The conference aimed to develop evidence-based recommendations for the use of FMT in treating *Clostridium difficile* infection (CDI) and other disorders associated with gut microbiota alterations. The consensus process involved an electronic Delphi method and a plenary meeting, with statements on FMT indications, donor selection, preparation of faecal material, clinical management, and basic requirements for establishing an FMT centre. The recommendations emphasize the importance of FMT as a highly effective treatment for recurrent CDI, with a strong recommendation for its implementation in clinical practice. The consensus report also highlights the need for standardized donor selection, preparation, and delivery protocols, as well as the establishment of FMT centres with appropriate facilities and governance. The report discusses the safety and efficacy of FMT, noting its excellent safety profile in the short term but acknowledging the lack of long-term data. It also addresses the use of FMT for other conditions, such as inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), but notes that evidence-based recommendations are limited. The consensus emphasizes the importance of rigorous donor screening, proper storage and preparation of faecal material, and the need for multidisciplinary teams to implement FMT centres. The report concludes with recommendations for regulatory frameworks, data collection, and long-term monitoring to ensure the safe and effective use of FMT in clinical practice.