Emergency living donor liver transplantation (LDLT) serves as a critical procedure for patients grappling with acute liver failure, acute-on-chronic liver failure, and decompensated cirrhosis. This review explores the indications, surgical techniques, challenges, and outcomes of emergency LDLT. Despite the inherent logistical and ethical complexities, carefully selected patients undergoing emergency LDLT achieve survival rates comparable to those seen in elective LDLT and deceased donor liver transplantation. Advances in surgical protocols, immunosuppression, and perioperative care continue to improve outcomes, though further research and standardized approaches are necessary to expand access and optimize results.